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

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Show simple item record Chappuis, F. en_US Rijal, S. en_US Jha, U. K. en_US Desjeux, P. en_US Karki, B. M. S. en_US Koirala, S. en_US Loutan, L. en_US Boelaert, M. en_US 2007-12-06T14:42:21Z 2007-12-06T14:42:21Z 2006 en_US
dc.identifier.issn 1360-2276 en_US
dc.identifier.other ITG-HLA en_US
dc.identifier.other HEALTH en_US
dc.identifier.other U-EPID en_US
dc.identifier.other JIF en_US
dc.identifier.other DOI en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.other FTB
dc.description The definitive version is available at
dc.description.abstract 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 > or = 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 (kappa = 0.87) than for the FGT (0.68) and the KAtex (0.43). All tests required < or = 20 min of actual work and < or = 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. en_US
dc.language English en_US
dc.publisher Blackwell Publishing
dc.subject Protozoal diseases en_US
dc.subject Leishmaniasis en_US
dc.subject Visceral en_US
dc.subject Kala azar en_US
dc.subject Rapid diagnostic tests en_US
dc.subject Sensitivity en_US
dc.subject Specificity en_US
dc.subject Feasibility en_US
dc.subject Comparative study en_US
dc.subject Nepal en_US
dc.subject Asia, South en_US
dc.title Field validity, reproducibility and feasibility of diagnostic tests for visceral leishmaniasis in rural Nepal en_US
dc.type Article en_US
dc.citation.issue 1 en_US
dc.citation.jtitle Tropical Medicine and International Health en_US
dc.citation.volume 11 en_US
dc.citation.pages 31-40 en_US Oxford
dc.citation.jabbreviation Trop Med Int Health en_US

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