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A Uggla - One of the best experts on this subject based on the ideXlab platform.

  • toxoplasma gondii seroprevalence in wild boars sus scrofa in sweden and evaluation of elisa Test performance
    Epidemiology and Infection, 2015
    Co-Authors: C Wallander, A Uggla, Jenny Frossling, Ivar Vagsholm, Anna Lunden
    Abstract:

    Toxoplasma gondii is a zoonotic protozoan parasite, infecting a wide range of warm-blooded animals. The Swedish wild boar population is expanding and increased hunting provides its meat to a growing group of consumers. We performed a spatio-temporal investigation of T. gondii seroprevalence in Swedish wild boars. An ELISA was set up and evaluated against a commercial Direct Agglutination Test, using Bayesian latent class analysis. The ELISA sensitivity and specificity were estimated to 79% and 85%, respectively. Of 1327 serum samples, 50% were positive. Thirty-four per cent of young wild boars and 55% of adults were positive (P < 0·001). The total seroprevalence ranged from 72% in 2005 to 38% in 2011 (P < 0·001), suggesting a declining trend. The highest seroprevalence, 65%, was recorded in South Sweden. In other regions it varied from 29% in Stockholm to 46% in East Middle Sweden.

  • serological survey of toxoplasma gondii infection in free ranging eurasian lynx lynx lynx from sweden
    Journal of Wildlife Diseases, 2006
    Co-Authors: Caroline Bröjer, Carl Hård Af Segerstad, Torsten Mörner, Mariepierre Ryserdegiorgis, Evabritt Jakubek, Desiree S Jansson, Anna Lunden, A Uggla
    Abstract:

    To investigate the prevalence of Toxoplasma gondii infection in free-ranging Eurasian lynx (Lynx lynx) in Sweden, serosanguinous fluids and feces were collected from 207 carcasses of lynx killed or found dead from 1996 to 1998. Sera were Tested for antibodies against T. gondii by the Direct Agglutination Test, and 156 (75.4%) of the sera Tested positive at antibody titers ≥40. Antibody prevalence was significantly lower in lynx originating from the northern parts of Sweden than in lynx from the more southern regions that are more densely populated by humans. Age-related differences also were found, with a significantly lower prevalence (55%) in juvenile (<1-yr-old) than in subadult and adult animals (82%). There was no significant difference in seroprevalence between males and females. Oocysts typical of T. gondii were not detected in any of the fecal samples.

  • serological diagnosis of neospora caninum infection
    International Journal for Parasitology, 1999
    Co-Authors: Camilla Björkman, A Uggla
    Abstract:

    Abstract Since the first isolation of the apicomplexan parasite Neospora caninum, a range of serological assays have been developed for use in dogs, cattle and a variety of other potential host species. The Tests include the inDirect fluorescent antibody Test, the Direct Agglutination Test and different enzyme-linked immunosorbent assays. This article reviews the principles and properties of the available Tests which are discussed in relation to different applications.

  • prevalence of antibodies to neospora caninum and toxoplasma gondii in cattle and water buffaloes in southern vietnam
    Veterinary Parasitology, 1998
    Co-Authors: Lam T T Huong, A Uggla, B L Ljungstrom, Camilla Björkman
    Abstract:

    Abstract Serum samples from 200 dairy cattle and 200 beef water buffaloes were collected in southern Vietnam during May to September 1995. The sera were analysed for antibodies to Neospora caninum by an enzyme-linked immunosorbent assay and the inDirect fluorescent antibody Test, and for antibodies to Toxoplasma gondii by the Direct Agglutination Test. Significant levels of N. caninum antibodies were detected in 5.5% of the cattle sera and in 1.5% of the water buffalo sera. 10.5% of the cattle sera and 3% of the water buffalo sera were found to contain T. gondii antibodies. Two of the cattle sera had both T. gondii and N. caninum antibodies. The present communication is the first to report serological evidence of N. caninum infection in the water buffalo.

Mehdi Mohebali - One of the best experts on this subject based on the ideXlab platform.

  • Molecular and serological evaluation of zoonotic visceral leishmaniasis in dogs in a rural area of Fars province, southern Iran, as a source of Leishmania infantum infection
    'Wiley', 2021
    Co-Authors: Laleh Najafi, Mehdi Mohebali, Mostafa Omidian, Zahra Rezaei, Saeed Shahabi, Fariba Ghorbani, Nasir Arefkhah, Zabiolla Zaraei, Bahador Sarkari
    Abstract:

    Abstract Canine visceral leishmaniasis (CVL) is endemic in the southern parts of Iran. The current study aimed at molecular and serological evaluation of zoonotic visceral leishmaniasis in dogs in Fars province, southern Iran. Blood samples were collected from 60 dogs in the three villages in Fars Province. Serum samples were Tested for antibodies against L. infantum by Direct Agglutination Test (DAT). DNA was extracted from each dog's buffy coat and Tested by PCR, targeting the Leishmania ITS‐2 region. From a total of 60 studied dogs, 25 (41.7%) were female, and 35 (58.3%) were male. Dogs' age ranged from 1 to 7 years, with a mean age of 2.97 (±1.4) years. Anti‐Leishmania antibodies were detected in sera samples of 28 (46.7%) dogs, (titre ≥ 1:320). Out of 28 seropositive cases, 13 (46.4%) were female, and 15 (53.6%) were male. Association between seropositivity and dogs’ clinical signs was statistically significant (p 

  • A comparative study of nested-PCR and Direct Agglutination Test (DAT) for the detection of Leishmania infantum infection in symptomatic and asymptomatic domestic dogs
    'Springer Science and Business Media LLC', 2021
    Co-Authors: Yonas Yimam Ayene, Mehdi Mohebali, Homa Hajjaran, Behnaz Akhoundi, Saeedeh Shojaee, Abbas Rahimi-foroushani, Mohammad Javad Abbaszadeh Afshar, Z Zarei
    Abstract:

    Abstract Objective Canine visceral leishmaniasis (CVL) is the main source of human visceral leishmaniosis (HVL) in Mediterranean region, including Iran and is spread from domestic dogs to Phlebotomine sand flies vectors to humans. To control the transmission of HVL, early and accurate detection of infected dogs is paramount importance despite it remains a confronting challenge. Herein, we evaluated the performance of Direct Agglutination Test (DAT) against gold standard nested polymerase chain reaction (nested-PCR) for CVL diagnosis in symptomatic and asymptomatic domestic dogs from endemic areas of Iran. Results Venous blood samples were collected from dogs without clinical signs (n  =  30) and with clinical signs (n  =  35) suggestive of Leishmania infantum infection. Among 65 samples examined, Leishmania DNA was detected by nested-PCR in 89.23% (58/65). Furthermore, 86.15% (56/65) nested-PCR positive samples were also DAT positive. The results of the DAT sensitivity Test were 96.43% and 96.67% in symptomatic and asymptomatic dogs, respectively, while the specificity was 100.00% and 60.00% in symptomatic and asymptomatic dogs, respectively. The results of this study also pointed out substantial concordance between DAT Test and nested-PCR method in both symptomatic dogs (Κ  =  0.783; P  

  • assessment of recombinant a2 latex Agglutination Test ra2 lat and ra2 elisa for detection of canine visceral leishman iasis a comparative field study with Direct Agglutination Test in northwestern iran
    Iranian Journal of Parasitology, 2018
    Co-Authors: Mahin Farahmand, Mehdi Mohebali, Hossein Nahrevanian, Vahid Khalaj, Mohammad Barati, Sanaz Naderi, Zabih Zarei, Ghader Khalili
    Abstract:

    Background: This study aimed to set-up latex Agglutination Test (LAT) and ELISA based on recombinant A2 from Iranian strain of Leishmania (L.) infantum (rA2-Ag) and evaluated for detection of anti- Leishmania antibodies in dogs compared to standard Direct Agglutination Test (DAT). Methods: The rA2-Ag was synthesized under a part of the A2 gene sequences which contain immune dominant sequences and less number of repetitive sequences. Latex beads, 0.8 μm (Sigma, USA) were sensitized with rA2-Ag. The Tests were carried out on sera collected from 350 ownership dogs including symptomatic (n=67), asymptomatic (n=230) canine visceral leishmaniasis (CVL), and (n=53) uninfected domestic dogs as control group. Results: Anti-leishmanial antibodies were detected in 97 (27.7%), 96 (27.4%) and 29 (%9) of the serum samples by using DAT, rA2-ELISA, and rA2-latex, respectively with ≥ 1:320 as a cut-off titer when DAT-confirmed cases were compared with the control groups. A combined sensitivity of 52% and specificity of 82.40% for rA2-ELISA and 23.8% and specificity 95.38%, respectively were found with ≥ 1:320 as a cut-off titer when DAT-confirmed cases were compared with the control groups. The concordance between rA2-ELISA and rA2 latex compared with DAT as a gold standard serological Test for VL were found 73.7% and 77.5%, respectively. Conclusion: A good degree of agreement was found between rA2-ELISA and DAT (73.7%). rA2-ELISA could detect more seropositive serum samples than rA2-LAT and it may be recommended as an alternative tool for the diagnosis of CVL.

  • Assessment of Recombinant A2-Latex Agglutination Test (RA2-LAT) and RA2-ELISA for Detection of Canine Visceral Leishman-iasis: A Comparative Field Study with Direct Agglutination Test in Northwestern Iran
    Tehran University of Medical Sciences, 2018
    Co-Authors: Mahin Farahmand, Mehdi Mohebali, Hossein Nahrevanian, Vahid Khalaj, Mohammad Barati, Sanaz Naderi, Zabih Zarei, Ghader Khalili
    Abstract:

    Background: This study aimed to set-up latex Agglutination Test (LAT) and ELISA based on recombinant A2 from Iranian strain of Leishmania (L.) infantum (rA2-Ag) and evaluated for detection of anti- Leishmania antibodies in dogs compared to standard Direct Agglutination Test (DAT).Methods: The rA2-Ag was synthesized under a part of the A2 gene sequences which contain immune dominant sequences and less number of repetitive sequences. Latex beads, 0.8 μm (Sigma, USA) were sensitized with rA2-Ag. The Tests were carried out on sera collected from 350 ownership dogs including symptomatic (n=67), asymptomatic (n=230) canine visceral leishmaniasis (CVL), and (n=53) uninfected domestic dogs as control group.Results: Anti-leishmanial antibodies were detected in 97 (27.7%), 96 (27.4%) and 29 (%9) of the serum samples by using DAT, rA2-ELISA, and rA2-latex, respectively with ≥1:320 as a cut-off titer when DAT-confirmed cases were compared with the control groups. A combined sensitivity of 52% and specificity of 82.40% for rA2-ELISA and 23.8% and specificity 95.38%, respectively were found with ≥1:320 as a cut-off titer when DAT-confirmed cases were compared with the control groups. The concordance between rA2-ELISA and rA2 latex compared with DAT as a gold standard serological Test for VL were found 73.7% and 77.5%, respectively.Conclusion: A good degree of agreement was found between rA2-ELISA and DAT (73.7%). rA2-ELISA could detect more seropositive serum samples than rA2-LAT and it may be recommended as an alternative tool for the diagnosis of CVL.

  • Canine Visceral Leishmaniasis; A Seroepidemiological Survey in Jiroft District, Southern Kerman Province, Southeastern Iran in 2015
    Tehran University of Medical Sciences, 2018
    Co-Authors: Mohammad Javad Abbaszadeh Afshar, Mehdi Mohebali, Iraj Sharifi, Mehdi Bamorovat, Mohammad Saleh Bahreini, Afsaneh Naderi
    Abstract:

    Background: Domestic dogs have been implicated as the main reservoir host of Mediterranean type of visceral leishmaniasis (VL) that is endemic in some parts of Iran. This study was performed about role of dogs in canine VL (CVL) epidemiology in Jiroft District, south of Kerman Province, southeastern Iran.Methods: Totally, 165 dogs including 100 stray and 65 sheepdogs were randomly selected. After complete clinical examination blood sample was taken from each dog. All the collected samples were examined following the serum separation by Direct Agglutination Test (DAT) for detection of anti-Leishmania infantum antibodies. The titers of ≥1:320 were defined as positive.Results: Overall, of 165 serum samples, 13 samples (7.9%) were positive by DAT at titers of ≥1:320. The seroprevalence was 11% among the stray dogs and 3% among the sheepdogs. There was no significant difference between stray and sheepdogs in CVL infection. The highest seroprevalence rate (14.3%) was found in seven-year old dogs.Conclusion: The present finding indicates the role of stray and sheepdogs in CVL epidemiology in this area. Further investigations are needed to evaluate the status of VL infection in human subjects in this area

Antti Sukura - One of the best experts on this subject based on the ideXlab platform.

  • Free-ranging Eurasian lynx (Lynx lynx) as host of Toxoplasma gondii in Finland
    Journal of wildlife diseases, 2013
    Co-Authors: Pikka Jokelainen, Juha Laakkonen, Katja Holmala, Gunita Deksne, Anu Naäreaho, Ilpo Kojola, Antti Sukura
    Abstract:

    We investigated the presence of Toxoplasma gondii infections in Eurasian lynx (Lynx lynx) in Finland by analyzing samples from 337 lynx that were legally hunted during the 2010–2011 season and by performing a retrospective nationwide database search of postmortem toxoplasmosis diagnoses in this species. We detected specific anti-T. gondii IgG antibodies in 290 (86.1%) of the 337 lynx. The method used was a Direct Agglutination Test, and samples positive at the used dilution 1:40 were defined as antibody positive. Older lynx had 14.3 times higher odds of being antibody-positive than did lynx of the presumed age of 7–10 mo, and lynx weighing >15 kg had 16.7 times higher odds of being antibody positive than did those ≤15 kg. Lynx from the southwest were more often antibody positive, with an odds ratio 6.3, than lynx from the northeast. None of the 332 fecal samples available was positive for the presence of T. gondii-like oocysts with a quantitative MgSO4 flotation technique, and none of the 167 free-ranging...

  • farmed wild boars exposed to toxoplasma gondii and trichinella spp
    Veterinary Parasitology, 2012
    Co-Authors: Pikka Jokelainen, Anu Nareaho, Outi Halli, Mari Heinonen, Antti Sukura
    Abstract:

    The meat of wild boar (Sus scrofa L.) can be a source of human infections with zoonotic parasites Toxoplasma gondii and Trichinella spp. We screened 197 wild boar sera collected at slaughter from 25 Finnish farms in 2007-2008 for serological evidence of infections with these parasites. Using a commercial Direct Agglutination Test at a serum dilution of 1:40, T. gondii-specific IgG antibodies were detected in 65 (33.0%) samples, on 14 (56.0%) farms. Females, animals older than 24 months, animals of small herds, and animals originating from south-western parts of Finland were more often T. gondii-seropositive than were males, younger animals, animals of larger herds, and animals originating from the north and east, respectively. Four (2.0%) of the sera, originating from three (12.0%) farms, Tested Trichinella-seropositive with an in-house ELISA and a conservative cut-off for seropositivity. One farm had both T. gondii- and Trichinella-seropositive animals. Taken together, an infection source had been present on 16 (64.0%) farms, and 69 (35.0%) of the 197 farmed wild boars intended for human consumption had specific serological evidence of exposure to a zoonotic parasite.

J P Dubey - One of the best experts on this subject based on the ideXlab platform.

  • Prevalence of antibodies to Leishmania infantum and Toxoplasma gondii in horses from the north of Portugal
    Parasites & Vectors, 2013
    Co-Authors: Ana Patrícia Lopes, J P Dubey, Luís Cardoso, Susana Sousa, Ana J Ribeiro, Ricardo Silvestre, Mário Cotovio, Henk Dfh Schallig, Anabela Cordeiro-da-silva
    Abstract:

    Background Leishmania infantum and Toxoplasma gondii are protozoa with zoonotic and economic importance. Prevalences of antibodies to these agents were assessed in 173 horses from the north of Portugal. Findings Antibodies to L. infantum were detected by the Direct Agglutination Test (DAT); seven (4.0%) horses were seropositive with DAT titres of 200 (n = 5), 800 (n = 1) and ≥ 1600 (n = 1). Antibodies to T. gondii were assayed by the modified Agglutination Test (MAT); 23 (13.3%) horses were seropositive with MAT titres of 20 (n = 13), 40 (n = 5), 80 (n = 3) and ≥ 160 (n = 2). No statistical differences were found among equine categories of gender (female, male and gelding), age (1.5–6, 7–12 and 13–30 years), type of housing (indoors and mixed/outdoors), ability (recreation, farming and sports) and clinical status (apparently healthy and sick) for both agents. Conclusions Horses are exposed to and may be infected with L. infantum and T. gondii in the north of Portugal.

  • prevalence of antibodies to trypanosoma cruzi toxoplasma gondii encephalitozoon cuniculi sarcocystis neurona besnoitia darlingi and neospora caninum in north american opossums didelphis virginiana from southern louisiana
    Journal of Parasitology, 2010
    Co-Authors: Alice E Houk, David G. Goodwin, Anne M. Zajac, Stephen C Barr, J P Dubey
    Abstract:

    Abstract We examined the prevalence of antibodies to zoonotic protozoan parasites (Trypanosoma cruzi, Toxoplasma gondii, and Encephalitozoon cuniculi) and protozoans of veterinary importance (Neospora caninum, Sarcocystis neurona, and Besnoitia darlingi) in a population of North American opossums (Didelphis virginiana) from Louisiana. Samples from 30 opossums were collected as part of a survey for T. cruzi in Louisiana. Frozen sera from these 30 opossums were examined using an inDirect immunofluorescent antibody Test (IFAT) against in vitro-produced antigenic stages of these protozoans. Additionally, 24 of the 30 samples were examined using hemoculture, and all 30 were examined in the modified Direct Agglutination Test (MAT) for antibodies to To. gondii. The prevalences of reactive IFAT samples were as follows: 60% for T. cruzi, 27% for To. gondii, 23% for E. cuniculi, 17% for S. neurona, 47% for B. darlingi, and 0% for N. caninum. Hemoculture revealed that 16 (67%) of 24 samples were positive for T. cruz...

  • Direct Agglutination Test for the detection of antibodies to sarcocystis neurona in experimentally infected animals
    Veterinary Parasitology, 2001
    Co-Authors: J P Dubey
    Abstract:

    Equine protozoal myeloencephalitis (EPM) is a serious neurological disease of horses in the Americas. The apicomplexan protozoan most commonly associated with EPM is Sarcocystis neurona. A Direct Agglutination Test (SAT) was developed to detect antibodies to S. neurona in experimentally infected animals. Merozoites of the SN6 strain of S. neurona collected from cell culture were used as antigen and 2-mercaptoethanol was added to the antigen suspension to destroy IgM antibodies when mixed with Test sera. Mice fed sporocysts of S. speeri or S. falcatula-like sporocysts from opossums did not seroconvert in the SAT. The sensitivity of the SAT was 100% and the specificity was 90% in mice.

  • seroprevalence of antibodies to neospora caniuum and toxoplasma gondii in water buffaloes bubalus bubalis from egypt
    International Journal for Parasitology, 1998
    Co-Authors: J P Dubey, S Romand, M Hilali, O C H Kwok, P Thulliez
    Abstract:

    Abstract Sera from 75 water buffaloes from Egypt were examined using a Direct Agglutination Test incorporating mercaptoethanol for antibodies to Neospora caninum and Toxoplasma gondii . Antibodies to N. caninum were found in 51 (68%) of 75 buffaloes in titres of 1:20 (six buffaloes), 1:40 (15 buffaloes), 1:160 (one buffalo), 1:320 (one buffalo) and ≥1:640 (28 buffaloes), using N. caninum formalin-preserved whole tachyzoites as antigen. Antibodies to T. gondii were not found in a 1:100 dilution of serum of any of the 75 buffaloes, using T. gondii as antigen, indicating specificity in the detection of antibodies to N. caninum . This is the first report of N. caninum prevalence in water buffaloes, which are economically very important domestic animals in developing countries.

  • Direct Agglutination Test for serologic diagnosis of neospora caninum infection
    Parasitology Research, 1997
    Co-Authors: Stephane Romand, P Thulliez, J P Dubey
    Abstract:

    A Direct Agglutination Test was evaluated for the detection and quantitation of IgG antibodies to Neospora caninum in both experimental and natural infections in various animal species. As compared with results obtained by the inDirect fluorescent antibody Test, the Direct Agglutination Test appeared reliable for the serologic diagnosis of neosporosis in a variety of animal species. The Direct Agglutination Test should provide easily available and inexpensive tools for serologic Testing for antibodies to N. caninum in many host species.

François Chappuis - One of the best experts on this subject based on the ideXlab platform.

  • case report visceral leishmaniasis with salmonella paratyphi and brucella melitensis coinfection as a cause of persistent fever in a patient from sudan
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Sayda El Safi, Marleen Boelaert, Hussam Elshikh, Enaam El Sanousi, Nagwa El Amin, Alfarazdag Mohammed, Kristien Verdonck, Jan Jacobs, François Chappuis
    Abstract:

    We describe the case of a 12-year-old boy from Sudan who presented with fever of 1-week duration, headache, cough, and vomiting. A set of diagnostic Tests led to the diagnosis of three infectious diseases: visceral leishmaniasis (probable diagnosis based on positive Direct Agglutination Test), enteric fever (blood culture grown with Salmonella Paratyphi), and brucellosis (blood culture grown with Brucella melitensis). The patient received specific treatment of the three infections and recovered. This case illustrates the occurrence and possible implications of coinfections in patients with persistent fever, including conditions that are hard to diagnose in field settings, such as brucellosis and enteric fever.

  • risk factors for visceral leishmaniasis and asymptomatic leishmania donovani infection in india and nepal
    PLOS ONE, 2014
    Co-Authors: Albert Picado, Marleen Boelaert, Suman Rijal, Shyam Sundar, Bart Ostyn, Shri Singh, Surendra Uranw, Epco Hasker, François Chappuis
    Abstract:

    There is increasing interest in the role of asymptomatic infection in transmission of Visceral Leishmaniasis (VL). We studied the individual, household and environmental factors associated with asymptomatic Leishmania donovani infected individuals and VL. 7,538 individuals living in VL endemic villages in India and Nepal were divided into three mutually exclusive groups based on their VL history and Direct Agglutination Test (DAT) results in yearly serosurveys over a two-year period. The groups were (1) VL cases, (2) asymptomatically infected individuals (seroconverters) and (3) seronegative individuals. VL cases and seroconverters were compared to seronegative individuals in mixed logistic regression models. The risk of seroconversion and disease was significantly increased in individuals aged 14 to 24 years old and by the presence of other DAT-positive, asymptomatically infected individuals and VL cases in the house. The risk of seroconversion was higher in Indian than in Nepalese villages and it increased significantly with age, but not so for VL. This study demonstrates that, when risk factors for leishmanial infection and VL disease are evaluated in the same population, epidemiological determinants for asymptomatic infection and VL are largely similar.

  • epidemiology of leishmania donovani infection in high transmission foci in nepal
    Tropical Medicine & International Health, 2010
    Co-Authors: Suman Rijal, François Chappuis, Albert Picado, Bart Ostyn, Surendra Uranw, Basudha Khanal, I S Paudel, Elisabeth Wreford Andersen, Filip Meheus, Clive R Davies
    Abstract:

    OBJECTIVE: Nepal reports a visceral leishmaniasis (VL) incidence of 5 per 10 000 per year on the basis of notification by health facilities, but little community-based epidemiological information exists. We report data on prevalence rates of Leishmania donovani infection in ten communities in East Nepal. METHODS: Ten clusters with highest VL incidence rates were purposefully selected in Nepal. All households were mapped and socio-demographic data and data on past VL incidence were collected. An exhaustive serological survey was performed of individuals aged >2 years, by collecting finger prick blood on filter paper in November-December 2006. The samples were Tested by Direct Agglutination, and a titre >or=1:1600 was taken as marker of infection. A generalized estimating equation (GEE) model was used to assess risk factors for Direct Agglutination Test (DAT) positivity taking into account the clustering at household and village level. RESULTS: The sero-survey (n = 5397) showed an infection prevalence rate of 9%, (range 5-15% per cluster) with higher prevalence in men (9.9%) than in women (8.3%) (P = 0.049). Male gender, increasing age and poverty were significant risk factors in the final GEE model. CONCLUSION: Leishmania infection rate in high-transmission areas in Nepal is associated with gender, age and socio-economic status.

  • A meta-analysis of the diagnostic performance of the Direct Agglutination Test and rK39 dipstick for visceral leishmaniasis
    BMJ, 2006
    Co-Authors: François Chappuis, Suman Rijal, Alonso Soto, Joris Menten, Marleen Boelaert
    Abstract:

    Abstract Objective To compare the performance of the Direct Agglutination Test and rK39 dipstick for the diagnosis of visceral leishmaniasis. Data sources Medline, citation tracking, January 1986 to December 2004. Selection criteria Original studies evaluating the Direct Agglutination Test or the rK39 dipstick with clinical visceral leishmaniasis as target condition; adequate reference classification; and absolute numbers of true positive, true negative, false positive, and false negative observations available or derivable from the data presented. Results 30 studies evaluating the Direct Agglutination Test and 13 studies evaluating the rK39 dipstick met the inclusion criteria. The combined sensitivity estimates of the Direct Agglutination Test and the rK39 dipstick were 94.8% (95% confidence interval 92.7% to 96.4%) and 93.9% (87.7% to 97.1%), respectively. Sensitivity seemed higher and more homogenous in the studies carried out in South Asia. Specificity estimates were influenced by the type of controls. In phase III studies carried out on patients with clinically suspected disease, the estimated specificity of the Direct Agglutination Test was 85.9% (72.3% to 93.4%) and of the rK39 dipstick was 90.6% (66.8% to 97.9%). Conclusion The diagnostic performance of the Direct Agglutination Test and the rK39 dipstick for visceral leishmaniasis is good to excellent and seem comparable.

  • evaluation of a urinary antigen based latex Agglutination Test in the diagnosis of kala azar in eastern nepal
    Tropical Medicine & International Health, 2004
    Co-Authors: Suman Rijal, Marleen Boelaert, Sharada Regmi, B M S Karki, Rupa Singh, François Chappuis, Marcel Hommel, Michael L. Chance, D. Jacquet, Philippe Desjeux
    Abstract:

    BACKGROUND We evaluated the diagnostic accuracy as well as the reproducibility of the urine latex Agglutination Test 'KAtex' in the diagnosis of kala-azar in patients recruited at a tertiary care centre in Dharan, Nepal, between November 2000 and January 2002. METHODS All patients presenting with fever of 2 weeks or more and splenomegaly were consecutively enrolled. Bone marrow and - if negative - spleen aspirates were examined for Leishmania donovani. Serum and urine samples were taken in duplicate for the Direct Agglutination Test (DAT) and KAtex. The reference laboratory determined sensitivity and specificity of KAtex. Reproducibility between both laboratories was assessed. RESULTS KAtex was performed on urine from 155 parasitologically confirmed kala-azar and 77 non-kala-azar cases (parasitology and DAT-negative). KAtex showed a sensitivity of 47.7% (74/155, 95% CI: 39.7-55.9) and a specificity of 98.7% (76/77, 95% CI: 93.0-100.0). Reproducibility of KAtex showed a kappa of 0.684 (P < 0.001, n = 232). CONCLUSION KAtex evaluation showed high specificity, low sensitivity and moderate reproducibility. A urine Test for kala-azar could become a real breakthrough in kala-azar management if its reproducibility and sensitivity could be further improved.