OBJECTIVE: To develop a new PCR for Leishmania detection and to estimate its diagnostic accuracy in a visceral leishmaniasis (VL) endemic area. METHODS: After providing the proof-of-concept, the diagnostic accuracy was estimated on blood from 247 non-endemic control persons and on blood and bone marrow from 173 confirmed VL, 39 probable VL and 87 non-VL patients from south-eastern Nepal. RESULTS: The PCR showed a specificity of 99.64% [95% confidence interval (CI): 98.93-100%) on non-endemic controls and a sensitivity of 92.1% (95% CI: 87.6-96.6%) on blood and 92.9% (95% CI: 89-96.8%) on bone marrow from the confirmed VL patients. Leishmania DNA was detected in blood and bone marrow of 67.6% (95% CI: 50.8-80.9%) and 71.8% (95% CI: 56.2-83.5%) of the probable VL patients, respectively, and of 38.2% (95% CI: 28-49.4%) and 29.9% (95% CI: 21.3-40.2%) of the non-VL patients, respectively. The PCR showed 97% concordance with a positive DAT status while for a negative DAT status this was only 41.3% (kappa-index 0.416, 95% CI: 0.30-0.53). CONCLUSIONS: Our findings indicate that PCR alone rather provides a marker for infection than a marker for disease and its role in VL diagnosis in endemic regions is discussed.
OBJECTIVE: To develop a new PCR for Leishmania detection and to estimate its diagnostic accuracy in a visceral leishmaniasis (VL) endemic area. METHODS: After providing the proof-of-concept, the diagnostic accuracy was estimated on blood from 247 non-endemic control persons and on blood and bone marrow from 173 confirmed VL, 39 probable VL and 87 non-VL patients from south-eastern Nepal. RESULTS: The PCR showed a specificity of 99.64% [95% confidence interval (CI): 98.93-100%) on non-endemic controls and a sensitivity of 92.1% (95% CI: 87.6-96.6%) on blood and 92.9% (95% CI: 89-96.8%) on bone marrow from the confirmed VL patients. Leishmania DNA was detected in blood and bone marrow of 67.6% (95% CI: 50.8-80.9%) and 71.8% (95% CI: 56.2-83.5%) of the probable VL patients, respectively, and of 38.2% (95% CI: 28-49.4%) and 29.9% (95% CI: 21.3-40.2%) of the non-VL patients, respectively. The PCR showed 97% concordance with a positive DAT status while for a negative DAT status this was only 41.3% (kappa-index 0.416, 95% CI: 0.30-0.53). CONCLUSIONS: Our findings indicate that PCR alone rather provides a marker for infection than a marker for disease and its role in VL diagnosis in endemic regions is discussed.
Authors: Anke E Kip; Manica Balasegaram; Jos H Beijnen; Jan H M Schellens; Peter J de Vries; Thomas P C Dorlo Journal: Antimicrob Agents Chemother Date: 2014-11-03 Impact factor: 5.191
Authors: Emily R Adams; Gerard J Schoone; Al Farazdag Ageed; Sayda El Safi; Henk D F H Schallig Journal: Am J Trop Med Hyg Date: 2010-04 Impact factor: 2.345
Authors: Narayan Raj Bhattarai; Gert Van der Auwera; Suman Rijal; Albert Picado; Niko Speybroeck; Basudha Khanal; Simonne De Doncker; Murari Lal Das; Bart Ostyn; Clive Davies; Marc Coosemans; Dirk Berkvens; Marleen Boelaert; Jean Claude Dujardin Journal: Emerg Infect Dis Date: 2010-02 Impact factor: 6.883
Authors: Alfarazdeg A Saad; Nuha G Ahmed; Osman S Osman; Ahmed Almustafa Al-Basheer; Awad Hamad; Stijn Deborggraeve; Philippe Büscher; Gerard J Schoone; Henk D Schallig; Thierry Laurent; Ahmed Haleem; Omran F Osman; Ahmed Mohamedain Eltom; Mustafa I Elbashir; Sayda El-Safi Journal: PLoS Negl Trop Dis Date: 2010-08-03