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Journal of Clinical Microbiology, February 2002, p. 475-479, Vol. 40, No. 2
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.3.475-479.2001
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Imported Visceral Leishmaniasis: Diagnostic Dilemmas and Comparative Analysis of Three Assays

Jamshaid Iqbal,1* Parsotam R. Hira,1 Grover Saroj,2 Reeni Philip,1 Faiza Al-Ali,3 Patrick J. Madda,4 and Ali Sher5

Department of Microbiology, Faculty of Medicine, Kuwait University,1 Infectious Diseases Hospital,2 Farwaniya Hospital Laboratory,3 AI-Amiri Hospital Laboratory,4 Ports and Borders, Health Division, Ministry of Health, Kuwait5

Received 30 July 2001/ Returned for modification 17 September 2001/ Accepted 9 November 2001

The present study evaluates the performances of three noninvasive serological assays for the detection of immunoglobulin G antibodies to leishmania antigen for the diagnosis of imported cases of kala azar (visceral leishmaniasis [VL]) in a country, Kuwait, where the disease is not endemic. A total of 323 individuals including 21 patients with documented cases of VL, 72 individuals with suspected cases of VL, 155 patients with other parasitic infections, and 75 healthy control individuals were tested by indirect hemagglutination assay (IHA; Behring Diagnostics GmbH, Marburg, Germany), indirect fluorescent-antibody assay (IFA; bioMerieux sa, Marcy l'Etoile, France), and a qualitative membrane-based immunoassay with recombinant leishmania antigen K39 (strip-test; Intersep Ltd, Berkshire, United Kingdom). Our data show that IHA is the most sensitive test (100%), followed by IFA (86.6%) and the strip-test (80.0%). The strip-test was the most specific (100%) of the three assays, followed by IFA (93.0%) and IHA (86.0%). However, the strip-test failed to detect at least three confirmed cases of VL. We conclude that IHA is preferred over IFA and the strip-test for the screening of individuals with suspected cases of VL, especially in a country where VL is not endemic and where the number of cases is regular but limited. The details about some of the patients with VL are presented to highlight the diversity of clinical presentations and problems encountered in the diagnosis of VL in a country where VL is not endemic.

* Corresponding author. Mailing address: Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait. Phone: (965) 531 2300/6781. Fax: (965) 533 2719. E-mail: iqbal{at}hsc.kuniv.edu.kw.

Journal of Clinical Microbiology, February 2002, p. 475-479, Vol. 40, No. 2
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.3.475-479.2001
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Sundar, S., Maurya, R., Singh, R. K., Bharti, K., Chakravarty, J., Parekh, A., Rai, M., Kumar, K., Murray, H. W. (2006). Rapid, Noninvasive Diagnosis of Visceral Leishmaniasis in India: Comparison of Two Immunochromatographic Strip Tests for Detection of Anti-K39 Antibody. J. Clin. Microbiol. 44: 251-253 [Abstract] [Full Text]  
  • MARTIN-SANCHEZ, J., PINEDA, J. A., MORILLAS-MARQUEZ, F., GARCIA-GARCIA, J. A., ACEDO, C., MACIAS, J. (2004). DETECTION OF LEISHMANIA INFANTUM KINETOPLAST DNA IN PERIPHERAL BLOOD FROM ASYMPTOMATIC INDIVIDUALS AT RISK FOR PARENTERALLY TRANSMITTED INFECTIONS: RELATIONSHIP BETWEEN POLYMERASE CHAIN REACTION RESULTS AND OTHER LEISHMANIA INFECTION MARKERS. Am J Trop Med Hyg 70: 545-548 [Abstract] [Full Text]  


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