Evaluation of a urinary antigen-based latex agglutination test in the diagnosis of kala-azar in eastern Nepal.
Trop Med Int Health
; 9(6): 724-9, 2004 Jun.
Article
em En
| MEDLINE
| ID: mdl-15189464
ABSTRACT
BACKGROUND:
We evaluated the diagnostic accuracy as well as the reproducibility of the urine latex agglutination test 'KAtex' in the diagnosis of kala-azar in patients recruited at a tertiary care centre in Dharan, Nepal, between November 2000 and January 2002.METHODS:
All patients presenting with fever of 2 weeks or more and splenomegaly were consecutively enrolled. Bone marrow and--if negative--spleen aspirates were examined for Leishmania donovani. Serum and urine samples were taken in duplicate for the Direct Agglutination Test (DAT) and KAtex. The reference laboratory determined sensitivity and specificity of KAtex. Reproducibility between both laboratories was assessed.RESULTS:
KAtex was performed on urine from 155 parasitologically confirmed kala-azar and 77 non-kala-azar cases (parasitology and DAT-negative). KAtex showed a sensitivity of 47.7% (74/155, 95% CI 39.7-55.9) and a specificity of 98.7% (76/77, 95% CI 93.0-100.0). Reproducibility of KAtex showed a kappa of 0.684 (P < 0.001, n = 232).CONCLUSION:
KAtex evaluation showed high specificity, low sensitivity and moderate reproducibility. A urine test for kala-azar could become a real breakthrough in kala-azar management if its reproducibility and sensitivity could be further improved.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Testes de Fixação do Látex
/
Leishmaniose Visceral
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Trop Med Int Health
Assunto da revista:
MEDICINA TROPICAL
/
SAUDE PUBLICA
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Nepal