Evaluation of dot enzyme-linked immunosorbent assay for mucocutaneous leishmaniasis and comparison with microplate enzyme immunoassay.

A dot enzyme-linked immunosorbent assay (dot ELISA) was evaluated and compared with a standard microplate ELISA (immunoglobulin G [IgG] ELISA) for the serological diagnosis of mucocutaneous leishmaniasis. The two assays were used to test 113 serum specimens from the following groups: normal individuals and patients with deep mycoses, toxoplasmosis, mucocutaneous leishmaniasis, visceral leishmaniasis, Chagas' disease, malaria, and schistosomiasis. Both tests exhibited cross-reactivity when testing specimens from cases of visceral leishmaniasis and Chagas' disease. The dot ELISA proved to be economical with respect to use of reagents and was easy to perform. Interpretation could easily be made by visual inspection of reaction endpoints in the nitrocellulose disks, obviating the need for spectrophotometric readings. There were no significant differences in sensitivity between the dot ELISA and the IgG ELISA at a cutoff level either of 20 or 40. However, its most remarkable feature was the high specificity compared with that of the IgG ELISA. Because of its ease of performance and high sensitivity and specificity, the dot ELISA should be an excellent test to be executed in the field during seroepidemiological surveys.