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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Diagnostic tests for kala-azar: a multi-centre study of the freeze-dried DAT, rK39 strip test and KAtex in East Africa and the Indian subcontinent
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 102, No. 1, Year 2008
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Description
Three diagnostic tests for visceral leishmaniasis (VL), the freeze-dried direct agglutination test (FD-DAT), the rK39 dipstick and a urine latex antigen test (KAtex), were evaluated for use in primary care in East Africa and the Indian subcontinent. Clinical suspects were prospectively recruited and tissue, blood and urine samples were taken. Direct microscopic examination of tissue smear, and FD-DAT, rK39 and KAtex were performed. Sensitivity and specificity with 95% credible intervals were estimated using Bayesian latent class analysis. On the Indian subcontinent both the FD-DAT and the rK39 strip test exceeded the 95% sensitivity and 90% specificity target, but not so in East Africa. Sensitivity of the FD-DAT was high in Ethiopia and Kenya but lower in Sudan, while its specificity was below 90% in Kenya. Sensitivity of the rK39 was below 80% in the three countries, and its specificity was only 70% in Ethiopia. KAtex showed moderate to very low sensitivity in all countries. FD-DAT and rK39 can be recommended for clinical practice on the Indian subcontinent. In East Africa, their clinical use should be carefully monitored. More work is needed to improve existing formats, and to develop better VL diagnostics. © 2007 Royal Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Boelaert, Marleen C.
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
El-Safi, Sayda Hassan
Sudan, Khartoum
Khartoum University
Hailu, Asrat
Ethiopia, Addis Ababa
School of Medicine
Mukhtar, Maowia Mohamed
Sudan, Khartoum
Khartoum University
Rijal, Suman
Unknown Affiliation
Sundar, Santhanam
India, Varanasi
Banaras Hindu University, Institute of Medical Sciences
Wasunna, Monique K.
Kenya, Nairobi
Kenya Medical Research Institute
Aseffa, Abraham
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Mbui, Jane K.
Kenya, Nairobi
Kenya Medical Research Institute
Menten, Joris
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Desjeux, Philippe M.P.
France
Institute for one World Health Iowh
Peeling, Rosanna Wai Wan
Switzerland, Geneve
Pde
Statistics
Citations: 193
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1016/j.trstmh.2007.09.003
ISSN:
00359203
Research Areas
Health System And Policy
Study Locations
Multi-countries
Ethiopia
Kenya
Sudan