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PCR y aglutinación directa como marcadores de infección por Leishmania entre sujetos nepalíes sanos, viviendo en áreas endémicas para kala‐azar
Author(s) -
Bhattarai Narayan Raj,
Van der Auwera Gert,
Khanal Basudha,
De Doncker Simonne,
Rijal Suman,
Das Murari Lal,
Uranw Surendra,
Ostyn Bart,
Praet Nicolas,
Speybroeck Niko,
Picado Albert,
Davies Clive,
Boelaert Marleen,
Dujardin JeanClaude
Publication year - 2009
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2009.02242.x
Subject(s) - medicine , direct agglutination test , asymptomatic , serology , immunology , antibody
Summary Objective To compare a PCR assay and direct agglutination test (DAT) for the detection of potential markers of Leishmania infection in 231 healthy subjects living in a kala‐azar endemic focus of Nepal. Methods The sample was composed of 184 (80%) persons without any known history of KA and not living in the same house as known kala‐azar cases (HNK), 24 (10%) Healthy Household Contacts (HHC) and 23 (10%) past kala‐azar cases which had been successfully treated (HPK). Results PCR and DAT positivity scores were, respectively: HNK, 17.6% and 5.6%; HHC, 12.5% and 20.8%; HPK, 26.1% and 95.7%. The ratio PCR‐positives/DAT‐positives was significantly higher in HNK (ratio = 3.1) than in HHC (ratio = 0.6, P = 0.036) and in HPK (ratio = 0.2, P = 0.012). The ratio PCR‐positives/DAT‐positives did not significantly differ between HHC (ratio = 0.6) and HPK (ratio = 0.2, P = 0.473). The positive agreement index between PCR and DAT in HNK was 5%; in HHC, 0%; in HPK, 43%. Conclusions Our study highlights the specific character of PCR and DAT for the exploration of Leishmania asymptomatic infections. PCR is probably more informative for very recent infections among HNK, while DAT provides more information among HHC and HPK, a feature likely related to the power of serology to track less recent infections.