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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Validation of Two Rapid Diagnostic Tests for Visceral Leishmaniasis in Kenya
PLoS Neglected Tropical Diseases, Volume 7, No. 9, Article e2441, Year 2013
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Description
Background:Visceral leishmaniasis (VL) is a systemic parasitic disease that is fatal unless treated. In Kenya, national VL guidelines rely on microscopic examination of spleen aspirate to confirm diagnosis. As this procedure is invasive, it cannot be safely implemented in peripheral health structures, where non-invasive, accurate, easy to use diagnostic tests are needed.Methodology:We evaluated the sensitivity, specificity and predictive values of two rapid diagnostic tests (RDT), DiaMed IT LEISH and Signal-KA, among consecutive patients with clinical suspicion of VL in two treatment centres located in Baringo and North Pokot District, Rift Valley province, Kenya. Microscopic examination of spleen aspirate was the reference diagnostic standard. Patients were prospectively recruited between May 2010 and July 2011.Principal Findings:Of 251 eligible patients, 219 patients were analyzed, including 131 VL and 88 non-VL patients. The median age of VL patients was 16 years with predominance of males (66%). None of the tested VL patients were co-infected with HIV. Sensitivity and specificity of the DiaMed IT LEISH were 89.3% (95%CI: 82.7-94%) and 89.8% (95%CI: 81.5-95.2%), respectively. The Signal KA showed trends towards lower sensitivity (77.1%; 95%CI: 68.9-84%) and higher specificity (95.5%; 95%CI: 88.7-98.7%). Combining the tests did not improve the overall diagnostic performance, as all patients with a positive Signal KA were also positive with the DiaMed IT LEISH.Conclusion/Significance:The DiaMed IT LEISH can be used to diagnose VL in Kenyan peripheral health facilities where microscopic examination of spleen aspirate or sophisticated serological techniques are not feasible. There is a crucial need for an improved RDT for VL diagnosis in East Africa. © 2013 Mbui et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3784478/bin/pntd.0002441.s001.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3784478/bin/pntd.0002441.s002.doc
Authors & Co-Authors
Mbui, Jane K.
Kenya, Nairobi
Kenya Medical Research Institute
Wasunna, Monique K.
Kenya, Nairobi
Kenya Medical Research Institute
Kenya, Nairobi
Drugs for Neglected Diseases Initiative
Balasegaram, Manica
Switzerland, Geneve
Drugs for Neglected Diseases Initiative
Laussermayer, Adrian
Switzerland, Geneva
Medecins Sans Frontieres
Juma, Rashid
Kenya, Nairobi
Kenya Medical Research Institute
Njenga, Simon Njoroge
Kenya, Nairobi
Kenya Medical Research Institute
Kirigi, George
Kenya, Nairobi
Kenya Medical Research Institute
Riongoita, Mark
Switzerland, Geneva
Medecins Sans Frontieres
de la Tour, Roberto
Switzerland, Geneva
Medecins Sans Frontieres
van Peteghem, Joke
Switzerland, Geneva
Medecins Sans Frontieres
Omollo, Raymond
Kenya, Nairobi
Kenya Medical Research Institute
Kenya, Nairobi
Drugs for Neglected Diseases Initiative
Chappuis, François P.
Switzerland, Geneva
Medecins Sans Frontieres
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Statistics
Citations: 14
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pntd.0002441
ISSN:
19352727
e-ISSN:
19352735
Research Areas
Infectious Diseases
Study Locations
Multi-countries
Kenya