Skip to main content

Free Content Field validity, reproducibility and feasibility of diagnostic tests for visceral leishmaniasis in rural Nepal

Download Article:

You have access to the full text article on a website external to Ingenta Connect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library

Summary Objectives 

To assess the field accuracy, reproducibility and feasibility of the formol gel test (FGT), the urine latex agglutination test (KAtex) and a rK39 antigen-based dipstick for the diagnosis of visceral leishmaniasis (VL) in rural Nepal. Method 

Patients with clinical suspicion of VL were recruited at Rangeli District Hospital (DH), a 15-bed government hospital located in south-eastern Nepal. FGT, KAtex and rK39 dipstick tests were performed on site and later repeated at a reference kala-azar diagnostic laboratory to assess reproducibility. Diagnosis of VL was confirmed by either a positive bone marrow aspirate examination or a positive direct agglutination test (DAT titre ≥1:3200) in patients who later responded to anti-leishmanial therapy. Results 

Of 155 patients initially recruited, 142 (85 with VL and 57 with another diagnosis) were included in the study. The sensitivity of the rK39 dipstick [89%; 95% confidence interval (CI): 81–94] was significantly higher than that of the KAtex (57%; 95% CI: 46–67) and the FGT (52%; 95% CI: 41–62). All three tests had a specificity of at least 90%. Agreement was higher for the rK39 dipstick ( = 0.87) than for the FGT (0.68) and the KAtex (0.43). All tests required ≤20 min of actual work and ≤40 min to obtain the results. Conclusion 

The rK39 dipstick was easy to do, more accurate and reproducible than other rapid diagnostic tests for VL in a DH of rural Nepal. It should be integrated into the field diagnostic algorithm of VL in this region and mechanisms to secure its availability should be found.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: Nepal; antigen detection; diagnosis; kala-azar; serology; visceral leishmaniasis

Document Type: Research Article

Affiliations: 1: Travel and Migration Medicine Unit, Geneva University Hospital, Geneva, Switzerland 2: Department of Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal 3: Rangeli District Hospital, Rangeli, Nepal 4: Disease Control, Prevention and Eradication, World Health Organization, Geneva, Switzerland 5: Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal 6: Institute of Tropical Medicine, Antwerp, Belgium

Publication date: 2006-01-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more