INTRODUCTION: The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points. METHODS: The results of laboratory tests for 4,256 patients with suspected ATL were analyzed, and 1,182 individuals were found to fulfill the established criteria. Two groups were formed. The positive cutaneous leishmaniasis (PCL) group included patients with skin lesions and positive direct search for parasites (DS) results. The negative cutaneous leishmaniasis (NCL) group included patients with skin lesions with evolution up to 2 months, negative DS results, and negative indirect immunofluorescence assay results who were residents of urban areas that were reported to be probable sites of infection at domiciles and peridomiciles. RESULTS: The PCL and NCL groups included 769 and 413 individuals, respectively. The mean ± standard deviation MST in the PCL group was 12.62 ± 5.91mm [95% confidence interval (CI): 12.20-13.04], and that in the NCL group was 1.43 ± 2.17mm (95% CI: 1.23-1.63). Receiver-operating characteristic curve analysis indicated 97.4% sensitivity and 93.9% specificity for a cut-off of 5mm and 95.8% sensitivity and 97.1% specificity for a cut-off of 6mm. CONCLUSIONS: Either 5mm or 6mm could be used as the cut-off value for diagnosing ATL, as both values had high sensitivity and specificity.
INTRODUCTION: The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points. METHODS: The results of laboratory tests for 4,256 patients with suspected ATL were analyzed, and 1,182 individuals were found to fulfill the established criteria. Two groups were formed. The positive cutaneous leishmaniasis (PCL) group included patients with skin lesions and positive direct search for parasites (DS) results. The negative cutaneous leishmaniasis (NCL) group included patients with skin lesions with evolution up to 2 months, negative DS results, and negative indirect immunofluorescence assay results who were residents of urban areas that were reported to be probable sites of infection at domiciles and peridomiciles. RESULTS: The PCL and NCL groups included 769 and 413 individuals, respectively. The mean ± standard deviation MST in the PCL group was 12.62 ± 5.91mm [95% confidence interval (CI): 12.20-13.04], and that in the NCL group was 1.43 ± 2.17mm (95% CI: 1.23-1.63). Receiver-operating characteristic curve analysis indicated 97.4% sensitivity and 93.9% specificity for a cut-off of 5mm and 95.8% sensitivity and 97.1% specificity for a cut-off of 6mm. CONCLUSIONS: Either 5mm or 6mm could be used as the cut-off value for diagnosing ATL, as both values had high sensitivity and specificity.
Authors: Daniel Eid; Miguel Guzman-Rivero; Ernesto Rojas; Isabel Goicolea; Anna-Karin Hurtig; Daniel Illanes; Miguel San Sebastian Journal: Am J Trop Med Hyg Date: 2018-01-01 Impact factor: 2.345
Authors: Priscila L Dos Santos; Fabrícia A de Oliveira; Micheli Luize B Santos; Luana Celina S Cunha; Michelle T B Lino; Michelle F S de Oliveira; Manuela O M Bomfim; Angela Maria Silva; Tatiana R de Moura; Amélia R de Jesus; Malcolm S Duthie; Steven G Reed; Roque P de Almeida Journal: PLoS Negl Trop Dis Date: 2016-01-27
Authors: Alejandro Javier Krolewiecki; Maria Cristina Almazan; Marcelo Quipildor; Marisa Juarez; Jose Fernando Gil; Marco Espinosa; Maria Canabire; Silvana Pamela Cajal Journal: PLoS Negl Trop Dis Date: 2017-10-05
Authors: Regina Maia de Souza; Heitor Franco de Andrade; Maria Irma Seixas Duarte; Lucia Maria Almeida Braz; Armando de Oliveira Schubach; Fátima Conceição Silva; Valdir Sabbaga Amato Journal: Rev Inst Med Trop Sao Paulo Date: 2017-04-03 Impact factor: 1.846
Authors: Daniel Eid; Miguel Guzman-Rivero; Ernesto Rojas; Isabel Goicolea; Anna-Karin Hurtig; Daniel Illanes; Miguel San Sebastian Journal: Trop Med Health Date: 2018-04-17