Evaluation and Comparison of Immunchromatography and Immunofluorescent Techniques in Diagnosis and Epidemiological Studies in Iraqi Kala-Azar.

Abstract

ABSTRACT:BACKGROUND:Infantile kala-azar is an endemic protozoal disease prevalent among children in Iraq. A rapid diagnostic laboratory tests are required for immediate treatment.OBJECTIVE:A prospective study was conducted in two pediatric hospitals in Baghdad during the period from Oct. 2005 to Sept. 2006 to evaluate the efficiency of immunochromatography strip test (IC) with rK39 antigen compared to indirect fluorescent antibody test (IFAT) for serodiagnosis of visceral leishmaniasis (VL) to investigate its use for epidemiological studies in Iraqi kala-azar.PATIENTSAND METHODS:The study included 54 proved cases for Leishmania donovani (L.D.) bodies in bone marrow, 108 clinically diagnosed cases, 38 with diseases other than VL (tuberculosis, acute amoebic dysentery, urinary schistosomiasis, brucellosis, toxoplasmosis and malaria) and 24 healthy controls. In addition of 3000 patients presented with fever, anaemia and hepatosplenomegaly.RESULT:The highest sensitivity of the sera was obtained by IC (92.6%) and by IFAT (96.3%), and the highest specificity by IC (100%) and by IFAT (86.8%). In the epidemiological study with rK39 strip test 66.1% positive reactions were obtained in patients with fever, anaemia and hepatosplenomegaly.CONCLUSION:IC strip test with rK39 antigen was more easy to perform but less sensitive than IFAT and the former was more specific than the latter