[CONFAMI study: Effects of home confinement during the COVID-19 epidemic on the lives of children and their families]. / Étude CONFAMI : effets du confinement durant l'épidémie de la COVID-19 sur la vie des enfants et leur famille.

OBJECTIVES: The aim of this study is to understand the changes within families during confinement motivated by the COVID-19 pandemic and to explore the psycho-emotional experiences of children and their parents in this new situation. Confinement necessarily induced significant changes in daily family routines, particularly for work, education, leisure and social activities. In the more vulnerable pediatric population, several authors have warned of the need to consider the impact of lockdown measures during COVID-19 on the psychological impact and well-being. METHOD: This is an anonymous online survey with methodology combining quantitative and qualitative analyses. The questions targeted several themes such as life context, emotional experience and the impact on daily habits in children and adolescents, as perceived by parents. Participants are adults and parents of at least one child. They were recruited through social media and email. RESULTS: A total of 439 parents responded to the questionnaire. The families generally stayed in their usual place of residence and managed to adapt well. On average, the children's level of worry (as estimated by parents) was lower than the level of worry parents attributed to themselves. For the majority, the parents did not observe any change, the psychological state of the children and adolescents was generally stable, but for those who experienced more negative emotions than usual, it was an increase in boredom, irritability and anger. A decrease in the quality of sleep was also observed by a third of the respondents. On the other hand, an increase in autonomy was noted. Regarding the quality of family cohabitation, an important result showed that confinement had improved family relationships for 41% parents but at the expense of usual social ties inducing a feeling of deprivation. Indeed, the participants evoke a lack of "social link" and "social contact with friends". Lack became synonymous with absence, a feeling of loneliness and separation. CONCLUSION: Our results confirm European and international data collected in children in countries where strict lockdown measures have been applied. Despite the negative emotions felt in some children, confinement has helped develop new resources in most families. Families seem to have been successful in maintaining a stable and secure routine which has certainly been a protective factor against anxiety. Some reported factors, such as bonding, could be protective factors and constitute good leads in interventions to be offered to children and their families.

An outbreak of Middle East Respiratory Syndrome (MERS) due to coronavirus in Al-Ahssa Region, Saudi Arabia, 2015.

Between 19 April and 23 June 2015, 52 laboratory-confirmed cases of Middle East Respiratory Syndrome due to coronavirus (MERS) were reported from Al-Ahssa region, eastern Saudi Arabia. The first seven cases occurred in one family; these were followed by 45 cases in three public hospitals. The objectives of this investigation were to describe the epidemiological characteristic of the cluster and identify potential risk factors and control measures to be instituted to prevent further occurrence of MERS. We obtained the medical records of all confirmed cases, interviewed the members of the affected household and reviewed the actions taken by the health authorities. All the cases were connected. The index case was a 62-year-old man with a history of close contact with dromedary camels; three of the seven infected family members and 18 people in hospitals died (case-fatality rate, 40.4%). The median incubation period was about 6 days. The cluster of cases appeared to be due to high exposure to MERS, delayed diagnosis, inadequate risk communication and inadequate compliance of hospital health workers and visitors with infection prevention and control measures.

[Neisseria meningitidis invasive infections in children in Tunis: about 79 cases]. / Les infections invasives a Neisseria meningitidis chez l'enfant a Tunis : a propos de 79 cas.

We conducted a retrospective study of meningococcal invasive diseases (MID) contracted in children in Tunis between January 1997 and January 2006. The purpose of this study is to specify the clinical, epidemiological, therapeutic and evolutionary features of these infections and to determine antimicrobial susceptibility and the antigenic formula of N. meningitidis isolates. During the study period, we have collected 79 cases of MID arising in children aged 3 days to 11 years. The majority of children's were less than of 4 years (57.3%). We note a frequency of the MID in winter and in spring. The most frequent clinical shape was meningitis (53%). Twenty one patients (26.6%) had a fulminant meningococcal disease. In our series, the rate of lethality was equal to 17.7%. Among the 46 meningococcal isolates, the most frequent serogroup was the B (73%) followed by C and A. A high heterogeneousness of the antigenic formulae was observed The most frequent phenotype was NT: NST for the group B isolates and 4:P1.13 for the group C ones. N meningitidis with reduced susceptibility to penicillin and to amoxicillin account for 54% and 10% of all isolates respectively. The cefotaxim and the rifampin were uniformly active.

[Imported malaria in Tunisia: consequences on the risk of resurgence of the disease]. / Paludisme d'importation en Tunisie: conséquences sur le risque de réintroduction de la maladie.

Although malaria has been eradicated in Tunisia since 1979, the disease is still a health issue due to the persistence of mosquitoes and coexistence with a potential parasite reservoir in the form of imported cases. From 1999 to 2006, 98 cases of imported malaria were diagnosed at the Pasteur Institute in Tunis where nearly 30% of national cases are recorded. Tunisians accounted for 24.5% of these cases versus 75.5% involving foreigners. The occurrence rate has steadily increased in volunteer workers, businessmen, diplomats and athletes who together accounted for 41.7% of cases in 1995 as compared to only 17.4% in 1980 (p<0.01). Most cases (96.5%) were imported from sub-Saharan Africa. The most frequent countries involved in importation were Cote d'Ivoire (23 cases) and Mali (8 cases) that are now linked to Tunisia by regular flights. About one third of patients were asymptomatic at the time of diagnosis. This finding underlines the importance of recommending systematic screening in high-risk groups. Fever (70.6%) and gastro-intestinal manifestations (27.9%) were the most frequent clinical findings in the 69 symptomatic cases. Plasmodium falciparum (71.4%) was the most common species followed by Plasmodium ovale (19.4%). Gametocytes were detected in 9.2% of subjects, thus creating a theoretical source of infection for mosquitoes especially since 60.2% of all cases were recorded between June and October when mosquitoes are active in Tunisia. Due to increasing exchange with endemic malaria areas in Africa that has resulted in a higher incidence of imported cases and a futher risk of introduction of tropical mosquito species as well as to global warming that promotes plasmodium transmission, greater vigilance is necessary to ensure eradication of malaria in Tunisia.

[Distribution of surgical hydatidosis in Tunisia, results of 2001-2005 study and trends between 1977 and 2005]. / L'incidence chirurgicale du kyste hydatique: en Tunisie: resultats de l'enquete 2001-2005 et tendance evolutive entre 1977-2005.

We have performed an exhaustive retrospective study in all surgical wards (54 services in 35 hospitals) which usually carry out surgical treatment of hydatic cysts in the country, covering the period between January 2001 and December 2005, in order to determine the annual surgical incidence of human cystic hydatidosis in Tunisia. A total of 6249 surgical interventions were recorded during the period 2001-2005. The highest proportion was recorded in the hospitals of Tunis District (42.9%). The service of thoracic surgery from Ariana hospital occupies the first rank (95%). The yearly incidence rate varies between 11 and 13.6 per 100,000. Calculated over the 5 years period, the incidence rate is 63.2 per 100,000 inhabitants, which means an average yearly incidence rate of 12.6 per 100,000 [12.28-12.99]. Governorates of the North West and the Western Central regions of the country are the most endemic area with an average annual incidence rates varying between 19.2 and 33.9 per 100,000, which is at least once and half higher than the national level. After 30 years (1977-2005), the average annual incidence rate slightly dropped, from 15 to 12.6 per 100,000, proving that such zoonosis remains a problem of public health in Tunisia. In order, to control in more or less short term this heavy burden disease and public health expenditure, the only efficient way is the prevention of the diseases with a mass treatment campaign of dogs, principal host of the parasite.

[Neonatal screening of G6PD deficiency in Tunisia]. / Depistage neonatal du deficit en G6PD en Tunisie.

The Glucose-6-phosphate dehydrogenase (G6PI) deficiency is the most common enzymopathy worldwide. WHO had classified Tunisia among countries that are moderately affected by this affection. However, no mass-screening reflecting the real incidence was realized. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis in Tunisia. A total of 1102 neonates, born in CMNT center of Maternity and of Neonatology of Tunis during the going periods from April, 2005 till May, 2005 and from June, 2006 till September, 2006, have been enclosed in the study. The samplings included 953peripheral venous blood and 149 blood cordon. Among 1102 samplings, only 976 were of use to the screening. In our mass-screening, we consider all newborns that were born in the CMNT during the period of study and were included in the screening. A dosage of the enzymatic activity was realized using spectrophotometric method. G6PD electrophoresis and molecular study by PCR/RFLP were realized for the overdrawn newborn children. Among 976 screening neonates, 43 individuals (4.4%) were found to be G6PD deficient by quantitative enzyme assay. Newborn affected were distributed in 23 boys and 20 girls (sex ratio of 1.15). The electrophoretic mobility and the molecular biology were realized for the affected newborn. Molecular characterization of 30 G6PD deficient neonates revealed that the G6PD A- was the most common and was detected in 20 of 43 individuals (66.7%), followed by G6PD Mediterranean that was detected in 6 (13.3%). At least, 4 other unknown mutations were not able to be determined by PCR/RFLP (n=4). In conclusion G6PD deficiency is frequent in our country, justifying a systematic neonatal screening, to avoid the arisen of grave consequences of this affection. The African variant is the most frequent in our country followed by the Mediterranean one.

[Use of the rapid antigen detection test in group A streptococci pharyngitis diagnosis in Tunis, Tunisia]. / Utilisation d'un test de diagnostic rapide des angines à streptocoque bêta-hémolytique du groupe A, auprès d'un échantillon d'enfants à Tunis, Tunisie.

The aims of this study were to determine the contribution of commercial rapid antigen detection test (RADT) in the rapid diagnosis of pharyngitis caused by group A streptococci. A total of 292 children with pharyngitis was included. A duplicate throat swabs was taken simultaneously from each patient. One of them was used for RADT achievement and the other for culture. When cultures were positive, a semi-quantitative evaluation was done. Throat culture and RADT were positive in 59 and 72 cases respectively. Fifty four specimens were positive simultaneously with RADT and culture and 215 specimens were negative using both methods. Eighteen specimens were positive only with RADT, 5 of them were treated by amoxicillin. Regarding to the group of patients with a negative RADT and a positive culture (5 cases), all of them had a culture evaluation at "+" or "++". Specificity and sensibility of the RADT were 92.2% and 91.5% respectively. RADT use by physicians can reduce antibiotic prescription among paediatric population. Because of the high specificity of RADT, therapeutic decisions can be made on the basis of a positive test.

[The current risk factors for hydatidosis in Tunisia]. / Les facteurs actuels d'endémicité de l'hydatidose en Tunisie.

Hydatidosis is a major public health problem in Tunisia. The presence of numerous stray dogs, widespread practice of sheep rearing and frequent slaughter of animals outside slaughterhouses are the main risk factors for spread of this zoonotic disease. Human behaviour associated with poor understanding of the parasite life cycle also has a negative impact. Health education is crucial for effective control. It should emphasize the damaging effects of uncontrolled slaughter, the exact role of dogs in parasite transmission and above all the need for adequate measures to sterilize infested viscera.

[Epidemiology of Leishmania (L.) infantum, L. major and L. killicki in Tunisia: results and analysis of the identification of 226 human and canine isolates]. / Epidémiologie de Leishmania (L.) infantum, L. major et L. killicki en Tunisie: résultats et analyse de l'identification de 226 isolats humains et canins et revue de la littérature.

The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolates), presents an unusual high proportion of L. infantum MON-24. In fact, this zymodeme, rather dermotropic is responsible for 47.2% of the cases vs 13% in the other regions of the country where L. infantum MON-1 remains predominant with 78.3% of typed isolates, the difference being statistically significant (P < 0.01). A third zymodeme, L. infantum MON-80 is sporadically pointed out during VL or in sporadic CL. Despite the high number of canine isolates (n=91) coming from 6 governorates, only the zymodeme L. infantum MON-1 was identified, letting hypothetic the reservoir of the 2 other zymodemes of the species identified in humans. Those absences may be related to cross infections, with a low sensitivity to L. infantum MON-24 leading to a selection of MON-1 at the time of culture passages. Hence it is important to develop molecular tools of direct identification on initial biological samples without going through cultures. Zoonotic CL remains the predominant cutaneous form in the central and southern area of Tunisia. However L. killicki, agent of the chronic CL, is confirming its presence out of its original focus of Tataouine in the southern-east of the country in both zoonotic CL and VL areas.

[Prevalence of osteoporotic fractures in Tunisian women]. / Prévalence des fractures ostéoporotiques chez la femme tunisienne.

PURPOSE OF THE STUDY: Osteoporotic fractures are an important public health problem due to significant morbidity and mortality and the socioeconomic burden. In Tunisia, the impact of such fractures is often underestimated due to lack of epidemiological data. We evaluated the prevalence of these fractures in a sample population at risk in order to better ascertain the amplitude of this problem in our country. MATERIAL AND METHODS: This prospective study involved 2,000 menopaused women aged 50 years or more. The sample was randomly selected among the population of Manouba, an urban administrative district of the capital of Tunisia. One thousand three hundred eleven women agreed to participate in this survey. Women with a risk of secondary osteoporosis were excluded. We retained for study fractures related to primary osteoporosis. History taking recorded anthropometric data and medical history, particularly gyn-ob history. All fractures occurring after minor trauma, in women aged 50 years or more, and involving the femoral neck, the wrist, or the proximal humerus were noted. Lateral x-rays of the thoracolumbar spine were studied to search for unrecognized vertebral fractures. RESULTS: The study population included 1,311 women, mean age 64.07 +/- 9.31 years, menopaused at mean 48.29 +/- 3.84 years. Among these women, 212 (16.2%) had presented a fracture at one of the localizations retained for study. Vertebral wedge fractures accounted for 59.83% of all fractures, wrist fractures 31.96%, proximal femoral fractures 4.51% and proximal humeral fractures 3.69%. DISCUSSION: Osteoporotic fractures are not uncommon in women in Tunisia. Increasing life expectancy in our country suggests this public health problem will grow in the years to come, pointing out the importance of better management of osteoporosis to prevent fractures.

Phlebotominae (Diptera: Psychodidae) of human leishmaniosis sites in Tunisia.

In order to identify the phlebotomine sandfly populations in Tunisian leishmaniosis foci, an entomological survey was carried out through three entomological seasons (2002-2003-2004) in 19 visceral and cutaneous leishmaniosis areas, located in six bioclimatic zones. Sandfly collections were based on light and sticky traps placed around human leishmaniosis cases. 8,722 phlebotomine sandflies belonging to 12 species were collected. The dominance of subgenus Larroussius species in northern foci, Phlebotomus papatasi in south-western foci and their co-dominance in the centre of the country is in accordance with the distribution of Leishmania infantum and L. major in Tunisia. The low density found in the historical zoonotic cutaneous leishmaniosis focus of Metlaoui in the south-west may indicate the high competence of the local populations. Studied phlebotomine settlements have showed a low specific diversity in most of the studied sites. In L. infantum areas, the dominant species were respectively: P. perfiliewi in the cutaneous leishmaniosis site of the humid bioclimatic stage, P. perniciosus in the cutaneous and visceral leishmaniosis foci of semi-arid and arid bioclimatic stages and P. longicuspis in the visceral leishmaniosis focus of saharan bioclimate. In the zoonotic cutaneous leishmaniosis foci, P. papatasi was a dominant species. In the well-known south-eastern foci of cutaneous leishmaniosis due to L. killicki, P. sergenti was a dominant species with P. perniciosus. In the central emerging foci of L. killicki, P. perniciosus was a dominant species in some sites whereas it was very rare in others. In these sites, the subgenus Paraphlebotomus was always present with a higher abundance of P. alexandri than P. sergenti.

[Management of arterial hypertension: results of a Tunisian general practitioner survey]. / Prise en charge de l'hypertension artérielle: résultats d'une enquête tunisienne aupres des medecins generalistes.

The control of arterial hypertension (HT) is an endlessly hoped objective but usually not reached. Several factors are determinants. The physician role is crucial in the HT prevention. In order to evaluate knowledge, attitudes and behaviours of Tunisian physicians in HT management, we conducted a cross sectional study in 2002 using a self administered questionnaire addressed to physicians working in private and public sectors. 380 generalists participated to this study. 95.5% of them confirmed that HT constitutes a public health problem. 81.1% saw at least 4 patients with HT a week. 95% insisted on the importance of the primary prevention. 90% took care themselves patients. 71.5% confirmed the importance of a training and an entrainement for the measure of the blood pressure (BP). 3.7% made diagnosis after a single visit and 10.9% confirmed it only from described symptoms. 20.4% of the generalists chose the old classification as objective level of BP. Thiazidic Diuretics and beta blockers were most prescribed medicines in first intention. 9.4% stopped the treatment after stabilization of blood pressure. 60% of generalists had inadequate behaviour facing a not stabilized BP. Non observance of treatment by patients was indicated by 31% of the generalists, cost and break of the medicines' stock and disappearance of symptoms were the main causes advanced by the generalists. This study shows the existence of gaps in generalists' practical behaviour treating this disease. Measures aiming the medical practice improvement turn out necessary in particular the sensitization of the generalists by an adequate university training and a continuous medical training, and a regular evaluation of the national program of hypertension prevention and management.

Vitamin D deficiency in Tunisia.

This study seeks to estimate the status of serum 25-hydroxyvitamin D [25(OH)D] in a healthy section of the population in Tunisia and to compare the achieved results with other published data. A transverse descriptive inquiry was carried out between January and March 2002. Three hundred and eighty-nine subjects aged 20-60 years were included in the study. A questionnaire was used to investigate clinical characteristics: sunlight exposure to ultraviolet light and, for women, parity, breast feeding, whether or not they wore the veil, and menopause. A dietary investigation estimated calcium and vitamin D intake. Morning fasting blood was collected from each subject for the measurement of the following parameters: serum calcium, phosphorus, albumin, alkaline phosphatase, 25(OH)D, parathyroid hormone (PTH). Hypovitaminosis D was defined by a cut-off of 37.5 nmol/l. The population studied was largely female, for the greater part housewives. The accumulated prevalence of hypovitaminosis D was 47.6%, increasing with age. Hypovitaminosis is highly prevalent in women (P<0.001). Multiparity, menopause, wearing the veil, and calcium and vitamin D dietary intake are factors associated with hypovitaminosis D (P<0.05). Analysis of logistic regression shows that only multiparity and vitamin D dietary intake are independent predictive factors. The status of serum 25(OH)D in Tunisia resembles that in southern European countries rather than in Middle Eastern countries. Insufficient vitamin D diet intake, higher parity and wearing the veil explain this deficiency in Tunisia. Dietary enrichment or supplementation by vitamin D and a more outdoor lifestyle, especially for older people, should be seriously considered as a way to reduce this deficiency in Tunisia.

[Importance of amastigote forms morphology to differentiate Leishmania infantum and Leishmania major species]. / Apport de la morphologie des formes amastigotes dans la différenciation des espèces Leishmania infantum et Leishmania major.

The microscopic study of the dermal smears of 62 cases of cutaneous leishmaniose, 27 infected by Leishmania (L.) infantum and 35 by L. major, showed that the amastigotes of L. infantum are meaningfully smaller (p < 0.001). This criteria is a simple pary alternative to distinguish these 2 species which have completely different epidemiology, recovery delay and prophylactic dispositions.

[Current aspects of Pott's disease in Tunisia. 29 cases]. / Aspects actuels du mal de Pott en Tunisie. A propos d'une série de 29 cas.

It is a retrospective study, reviewing all cases of vertebral tuberculosis recorded between 1989 and 1999 in La Rabta Hospital (Tunis). 29 patients have been included whose average age was 49 years. The main symptoms which appeared within a average period of six months were vertebral pain, associated with fever in half of the cases. The diagnosis of infectious spondylitis was made according to the results of Computer tomography in 26 cases. The diagnosis of infection was confirmed by characteristic histological pattern and/or culture biopsy. 27 patients were cured without complications except for 2 of them who developed a spinal cord compression. This complication was quickly stemmed by steroid therapy.

[Receptivity of the Tunisian to malaria after its eradication: analysis of the situation for adequacy of the surveillance]. / Réceptivité de la Tunisie au paludisme après son éradication: analyse de la situation pour une adéquation de la surveillance.

In Tunisia, there has been no local transmission of malaria since 1979. Although the disease has been eradicated, its re-emergence is not considered impossible. An epidemiological evaluation has been conducted in order to evaluate the current level of receptivity. A. labranchiae and A. sergenti, the former vectors of malaria in the country, are still present and the anopheline population in the country is increasing following the building of dams and manmade lakes. It is hoped that Tunisian vectors are refractory to sub-Saharan strains of malaria parasites. According to the data collected regarding malaria history, climate, geography and socio-economic development, we assume that the receptivity level of the country is low and the risk of re-emergence of local foci is small.

[Sero-epidemiologic profile of toxoplasmosis in northern Tunisia]. / Profil séro-épidémiologique de la toxoplasmose au nord de la Tunisie.

Toxoplasma antibodies prevalence was studied in the north of Tunisia where a mild climate prevails. Two groups of individuals were investigated: 857 living in rural area and 564 living in urb town. Sera were analysed by ELISA and indirect immunofluorescence. The overall prevalence was 58.4%. It roses from 24.5% at ten years to 52.1% at 20 years of age. A maximum level, around 70%, was reached by about 30 years. The risk of acute infection after this age seemed low as judging by the proportion of high antibodies titers observed in this group (14.2% before 30 years vs 3.7% after). A significantly higher prevalence was detected in urban residents (67% vs 52.8%). In this group, the rate of seroconversion seems the highest between ten and 20 years of age and the majority of women are infected before reaching childbearing age. In the rural area, the seropositivity is lower between ten-20 years and many women at childbearing age still susceptible to toxoplasmosis. The risk of acute infection seems higher in the youngest ones as showed by the proportion of high antibodies titers observed in the 18-30 age group (9.2%) compared to the one observed after 30 years (1.9%).

[Availability and use of emergency services in Tunisia: principal results of an exhaustive national survey]. / L'offre et l'utilisation des services d'urgence en Tunisie : principaux résultats d'une enquête nationale exhaustive.

In order to assess hospital emergency rooms, a comprehensive national epidemiological investigation was conducted in all 155 public emergency structures in Tunisia. Here we present the main results of the levels of availability and use of emergency services. Coverage of the population by services is adequate (one emergency service per 60,000 people). Emergency wards admit about 2,500,000 patients every year (a quarter of the population of the country). The university hospital emergency services are the most heavily used (150 patients per day on average). Emergency services are sought for medical (60%), surgical (18%), paediatric (14%) and gynaecological reasons (5%). It would be useful to assess the quality of care delivered and the satisfaction of citizens and health workers.

[General physicians and general medicine: social image and public opinion]. / Médecin généraliste et médecine générale: image sociale et représentation de la population.

During the last two decades, importance of general practice of medicine was more recognised. The kind of interest was different between Health decision makers and population. For Health decision makers, revalorisation of general medicine is the better solution we could develop in order to improve efficiency of the health care financing systems. However, From the side of population social image of the general physician is going down. In order to investigate the population view point about general practitioner, we conduct a trial next to 289 persons living Tunis area. Peoples recognized to the general practitioner some qualities: Useful for first aid, he integrates all aspects of the morbidity, initiates best relations with his patients and appropriately manages medical files. In the other side, He's less qualified than the specialist to take appropriate decision, for monitoring and for the quality of communication with patients. He' also lack of technicality and investigation procedures. Ours results indicate how it is urgent to lead a reform of teatching of general medicine in the country.

[Role of direct agglutination test (DAT) in the diagnosis of visceral leishmaniasis in Tunisia]. / Apport du test d'agglination directe (DAT) dans le diagnostique de la leishmaniose viscerale en Tunisie.

Direct agglutination test (DAT) is a simple ans economical technique for visceral leishmaniasis diagnosis. An evaluation, held in Tunisia with 41 confirmed visceral leishmaniasis cases and 58 negative controls, showed a sensitivity of 95.1% and a specificity of 96.5%. These results were highly correlated with those of ELISA and fluorescent antibody test. The use of DAT in our country will be very relevant, mainly in district hospitals, where others classical tests are not available. It will also be useful during sero-epidemiological studies on both human and canine visceral leishmaniasis.