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Clinical and Diagnostic Laboratory Immunology, October 2005, p. 1191-1194, Vol. 12, No. 10
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.10.1191-1194.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Potential of Direct Agglutination Test Based on Promastigote and Amastigote Antigens for Serodiagnosis of Post-Kala-Azar Dermal Leishmaniasis

Ruchi Singh,1 B. V. Subba Raju,1 R. K. Jain,2 and Poonam Salotra1*

Institute of Pathology (ICMR),1 Department of Dermatology, Safdarjung Hospital, New Delhi 110029, India2

Received 9 June 2005/ Returned for modification 11 July 2005/ Accepted 9 August 2005

Post-kala-azar dermal leishmaniasis (PKDL) is a dermal complication, a sequel to kala-azar. Diagnosis of PKDL presents a challenge due to the low parasite burden in the lesions. The direct agglutination test (DAT) based on promastigote and amastigote antigens of Leishmania donovani of indigenous isolates was developed to diagnose PKDL, and the results were compared with those of the rk39 strip test. The sensitivities of DAT for antileishmanial antibody detection, based on promastigote and amastigote antigens at a cutoff titer of 1:800 were 98.5% and 100%, respectively, with corresponding specificities of 96.5% and 100%. DAT could correctly detect 100% polymorphic cases and 95.4% macular PKDL cases. In comparison, the rk39 strip test was able to correctly diagnose 95.6% of polymorphic and 86.0% macular PKDL cases. DAT based on axenic amastigote antigen provided 100% sensitivity and specificity, making it particularly useful for macular PKDL cases, which are often missed by the rk39 strip test. Thus, DAT provides a simple, reliable, and inexpensive test for PKDL diagnosis with potential applicability in field conditions.

* Corresponding author. Mailing address: Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi 110029, India. Phone: 91-11-26166124. Fax: 91-11-26198401. E-mail: salotra{at}vsnl.com.

Clinical and Diagnostic Laboratory Immunology, October 2005, p. 1191-1194, Vol. 12, No. 10
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.10.1191-1194.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.





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Copyright © 2005 by the American Society for Microbiology. All rights reserved.