Multicentre evaluation of a direct agglutination test prototype kit (DAT-LPC) for diagnosis of visceral leishmaniasis.

In this study, we assessed the sensitivity, specificity, and diagnostic accuracy of a previously developed direct agglutination test (DAT) using a freeze-dried antigen derived from Leishmania infantum promastigotes and composed in a prototype kit for visceral leishmaniasis (VL) diagnosis, named DAT-LPC. To evaluate DAT-LPC reproducibility, the kit was used to analyse 207 serum samples from VL patients and 80 serum samples from patients with other parasitic infections or healthy subjects in four laboratories from different public health institutions in Brazil. DAT-LPC showed sensitivity between 96·2 and 99·5% (P = 0·14), specificity ranging from 96·2 to 97·5% (P = 0·95), and diagnostic accuracy ranging from 96·5 to 99% (P = 0·34). The inter-laboratory reproducibility of qualitative results was classified as excellent (κ index: 0·94-0·97). The reproducibility of the end-titre results in relation to the reference laboratory, ranged from 31 to 85%. These results demonstrate an excellent performance of the DAT-LPC, and validate it for the diagnosis of VL that could replace the immunofluorescent antibody test as the routine diagnostic test in the Brazilian public health system.

Freqüência de aglutininas anti-Leptospira interrogans em eqüídeos, em Minas Gerais, 2003 a 2004 / Frequency of anti-Leptospira interrogans agglutinins in equidae in Minas Gerais, Brazil, from 2003 to 2004

The goal of this research was to find the frequency and spatial distribution of infection caused by Leptospira interrogans in equidae in Minas Gerais State from September 2003 to March 2004. Samples of blood serum (6,475) were analyzed by microscopic agglutination test. From the total, 381 samples were positive (5.9 percent), with title equal or superior to 1:200 for one or more serovars of leptospira. The most frequent serovars were Hardjo (Norma), Pomona, Bratislava, and Batavie. The higher frequency of equidae reagents were recorded at the North and Northeast region of Minas Gerais, followed by Triângulo Mineiro and Alto Paranaíba, then Central, West, Metropolitan area of Belo Horizonte, and South/Southwest.

Aspectos epidemiológicos da leishmaniose visceral canina no município de Pedro Leopoldo, Minas Gerais, 2003 / Epidemiologic aspects of canine visceral leishmaniasis in Pedro Leopoldo district, Minas Gerais, 2003

Determinou-se a prevalência da leishmaniose visceral canina (LVC) no município de Pedro Leopoldo, MG, 2003, por meio de inquérito soro-epidemiológico. Coletaram-se amostras de sangue de 2.185 cães e aplicou-se questionário semi-estruturado em cada residência. Os animais foram divididos em quatro grupos, sendo o grupo A constituído de 1240 cães das áreas urbana e rural; o grupo B de 705 cães de áreas em torno dos focos; o grupo C, de 134 cães, cujas amostras foram coletadas durante o dia da vacinação anti-rábica oficial; e o grupo D composto de 111 cães errantes. Os dados foram armazenados em banco de dados EPIINFO 6.04b. Os 36 cães positivos foram localizados espacialmente com auxílio de GPS (Global Positioning System), e o georreferenciamento realizado por meio do programa AUTOCAD 2000. A prevalência global da LVC foi de 1,4 por cento e variou de 1,1 por cento na área urbana e 4,2 por cento na rural. Estes resultados permitiram concluir que Pedro Leopoldo, de acordo com a classificação oficial do Ministério da Saúde, é área silenciosa, receptiva e vulnerável para LVC. A distribuição espacial dos casos é diferenciada e requer medidas sanitárias de acordo com cada área de risco.

The prevalence of canine visceral leishmaniasis (CVL) in Pedro Leopoldo district, 2003 was evaluated. A serum-epidemic inquiry was accomplished by collecting blood samples of dogs and by applying a semi structured questionnaire, according to groups, in each visited residence: group A, constituted of 1240 dogs of the urban and rural areas; group B, constituted of 705 dogs sampled around the focuses; group C, constituted of 134 dogs, wich samples were collected during the canine/feline antirabic vaccination; and group D, constituted of 111 wandering dogs. The data were stored in the EPI INFO 6.04b database. Positive dogs were spatially located using GPS (Global Positioning System) and the geographycal reference was made through the AUTOCAD 2000 program. The district global prevalence for canine visceral leishmaniasis was of 1.4 percent, varying from 1.1 percent to 4.2 percent. These results allowed to conclude that Pedro Leopoldo is a silent area, receptive and vulnerable to CVL, in agreement with the Ministry of Health official classification. The spacial distribution of CVL is not homogeneous and it requires sanitary measures according to each risk area. The obtained knowledge allows to establish effective strategies for the control of CVL in that distric.