DETECTION OF LEISHMANIA INFANTUN ANTIGENS IN URINARY SAMPLES BY KATEX AND ITS COMPARISON WITH SEROLOGICAL METHODS

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KHADEMVATAN SH.; MAZLOUMI S.; FALLAH E.; SAKI J.

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Journal: Internal Medicine Today Year:2011 | Volume:17 | Issue:2 (51) Page(s): 20-26

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Title

DETECTION OF LEISHMANIA INFANTUN ANTIGENS IN URINARY SAMPLES BY KATEX AND ITS COMPARISON WITH SEROLOGICAL METHODS

Author(s)

KHADEMVATAN SH. | MAZLOUMI S. | FALLAH E. | SAKI J. | Issue Writer Certificate

Keywords

DIAGNOSISQ3

IRANQ2

URINEQ3

VISCERAL LEISHMANIASISQ3

Abstract

Background and Aim: VISCERAL LEISHMANIASIS is endemic at least in three provinces of our country, IRAN, including Ardabil, Fars and East Azarbayejan. The disease is of Mediterranean type in IRAN and affects mainly children. Therefore, the early DIAGNOSIS and treatment of this disease can prevent its high mortality (95%). Because of the invasion of bone marrow aspiration or biopsy and limitations in the others methods, several studies have been done to use simple tests for the DIAGNOSIS of Leishmania infantum in children that KAtex test to detect the urinary antigens is one of them. The aim of this study was to evaluate the efficiency of KAtex test in the DIAGNOSIS of VISCERAL LEISHMANIASIS and possible replacement with serological methods (IFA, DAT, Elisa IgG & IgM) in endemic areas.Materials and Methods: This was a cross-sectional, descriptive and epidemiologic study, which was conducted in Ahar and Kalybar villages of East Azarbayejan as endemic areas. KAtex kit was used for DIAGNOSIS in 72 confirmed and historic Kala-azar patients and for case finding among 313 children in the endemic area of Kalibar & Ahar, East Azerbaijan province, the northwest of IRAN. The results were also compared with serologic tests (DAT, IFA, and Elisa- IgG & IgM) to determine any possible agreement and validity & reliability indexes. Kappa and McNemar were used for data analysis.Results: From 385 of urinary samples, 38 (9.8%) were positive by KAtex test. The rapid KAtex test had sensitivity of 77.7% and quite specificity (98.2%) in the DIAGNOSIS of human VISCERAL LEISHMANIASIS. Highest and lowest agreements of KAtex test were with Elisa- IgM (kappa = 0.834, P= 0.549) and DAT (kappa=0.400, P< 0.001), respectively. Also, this test did not have any cross reaction with tuberculosis, toxoplasmosis and brucellosis patients' URINE samples.Conclusion: The KAtex test is rapid, non-invasive and simple. It does not require much expertise or elaborate equipment; and it can be used for the DIAGNOSIS of VISCERAL LEISHMANIASIS in remote endemic areas.Also, because KAtex discriminates between active diseases, sub-clinical and past infection, its results can complete DAT for the DIAGNOSIS of unconfirmed VISCERAL LEISHMANIASIS cases.

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