Field evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopia

Hdl Handle:
http://hdl.handle.net/10144/114143
Title:
Field evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopia
Authors:
ter Horst, Rachel; Tefera, Tewodros; Assefa, Gessesse; Ebrahim, Abdurazik Z; Davidson, Robert N; Ritmeijer, Koert
Journal:
The American Journal of Tropical Medicine and Hygiene
Abstract:
Accuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive.
Affiliation:
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
Issue Date:
1-Jun-2009
URI:
http://hdl.handle.net/10144/114143
PubMed ID:
19478251
Additional Links:
http://www.ajtmh.org/cgi/pmidlookup?view=long&pmid=19478251
Submitted date:
2010-10-15
Type:
Article
Language:
en
ISSN:
1476-1645
Appears in Collections:
Leishmaniasis/Kala Azar

Full metadata record

DC FieldValue Language
dc.contributor.authorter Horst, Rachelen
dc.contributor.authorTefera, Tewodrosen
dc.contributor.authorAssefa, Gessesseen
dc.contributor.authorEbrahim, Abdurazik Zen
dc.contributor.authorDavidson, Robert Nen
dc.contributor.authorRitmeijer, Koerten
dc.date.accessioned2010-10-29T15:16:10Z-
dc.date.available2010-10-29T15:16:10Z-
dc.date.issued2009-06-01-
dc.date.submitted2010-10-15-
dc.identifier.citationAm. J. Trop. Med. Hyg. 2009;80(6):929-34en
dc.identifier.issn1476-1645-
dc.identifier.pmid19478251-
dc.identifier.urihttp://hdl.handle.net/10144/114143-
dc.description.abstractAccuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive.en
dc.language.isoenen
dc.relation.urlhttp://www.ajtmh.org/cgi/pmidlookup?view=long&pmid=19478251en
dc.rightsArchived with thanks to The American Journal of Tropical Medicine and Hygieneen
dc.subject.meshAdulten
dc.subject.meshAgglutination Testsen
dc.subject.meshEthiopiaen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHumansen
dc.subject.meshLeishmaniasis, Visceralen
dc.subject.meshMaleen
dc.subject.meshOdds Ratioen
dc.subject.meshPrevalenceen
dc.subject.meshReagent Kits, Diagnosticen
dc.subject.meshSensitivity and Specificityen
dc.titleField evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopiaen
dc.typeArticleen
dc.contributor.departmentMédecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlandsen
dc.identifier.journalThe American Journal of Tropical Medicine and Hygieneen

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