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Accuracy of a rapid diagnostic test based on antigen detection for the diagnosis of cutaneous leishmaniasis in patients with suggestive skin lesions in Morocco

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dc.contributor.author Bennis, I. en_US
dc.contributor.author Verdonck, K. en_US
dc.contributor.author El Khalfaoui, N. en_US
dc.contributor.author Riyad, M. en_US
dc.contributor.author Fellah, H. en_US
dc.contributor.author Dujardin, J. C. en_US
dc.contributor.author Sahibi, H. en_US
dc.contributor.author Bouhout, S. en_US
dc.contributor.author Van der Auwera, G. en_US
dc.contributor.author Boelaert, M. en_US
dc.date.accessioned 2019-06-04T12:21:02Z
dc.date.available 2019-06-04T12:21:02Z
dc.date.issued 2018 en_US
dc.identifier.issn 0002-9637 en_US
dc.identifier.doi http://dx.doi.org/10.4269/ajtmh.18-0066 en_US
dc.identifier.other http://lib.itg.be/pdf/itg/2018/2018ajtm0716.pdf en_US
dc.identifier.other 38 en_US
dc.identifier.other ITG-H1B; ITG-H2A; ITG-B6A; ITG-B9A; ITG-HLA; MULTI; DPH; U-ECTD; DBM; U-MOLPAR; JIF; DOI; PDF; Abstract; ITMPUB; DSPACE65 en_US
dc.identifier.uri http://hdl.handle.net/10390/10664
dc.description.abstract In rural areas in Morocco, diagnosing cutaneous leishmaniasis (CL) can be challenging. We evaluated the accuracy of a rapid diagnostic test (RDT) based on antigen detection, CL Detect Rapid Test() (Inbios International Inc., Seattle, WA), in this setting. We consecutively recruited patients with new skin ulcers in nine primary health centers. We took a dental broach sample for the RDT and two other tissue samples by scraping the border and center of the lesion with a scalpel and smearing it on a slide. We duplicated each smear by pressing a clean slide against it and processed the slides by using microscopy, polymerase chain reaction (PCR) internal transcribed spacer 1, and kDNA minicircle PCR. In a subgroup with positive PCR, the Leishmania species was identified using PCR-restriction fragment length polymorphism and PCR-sequencing of hsp70 genes. A participant with positive microscopy and/or PCR was considered a confirmed CL case. We computed sensitivity (Se) and specificity (Sp) of the RDT compared with this reference standard (ClinicalTrials.gov registration: NCT02979002). Between December 2016 and July 2017, we included 219 patients, 50% of them were under 18 years old. Rapid diagnostic test Se was 68% [95% confidence interval (CI): 61-74], Sp 94% [95% CI: 91-97], positive predictive value 95% [95% CI: 92-98], and negative predictive value 64% [95% CI: 58-70]. Despite its low Se, this novel RDT is a useful addition to clinical management of CL in Morocco, especially in isolated localities. Rapid diagnostic test-positive lesions can be treated as CL; but when RDT negative, microscopy should be performed as a second step. The Se of the RDT can probably be optimized by improving the sampling procedure. en_US
dc.language English en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/29988004 en_US
dc.subject Leishmaniasis en_US
dc.subject Cutaneous en_US
dc.subject Protozoal diseases en_US
dc.subject Diagnosis en_US
dc.subject Rapid diagnostic tests en_US
dc.subject Accuracy en_US
dc.subject Skin lesions en_US
dc.subject Morocco en_US
dc.subject Africa-North en_US
dc.title Accuracy of a rapid diagnostic test based on antigen detection for the diagnosis of cutaneous leishmaniasis in patients with suggestive skin lesions in Morocco en_US
dc.type Article en_US
dc.citation.issue 3 en_US
dc.citation.jtitle American Journal of Tropical Medicine and Hygiene en_US
dc.citation.volume 99 en_US
dc.citation.pages 716-722 en_US
dc.citation.abbreviation Am J Trop Med Hyg en_US


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