PCR and direct agglutination as Leishmania infection markers among healthy Nepalese subjects living in areas endemic for Kala-Azar

• Published in: Tropical medicine & international health Vol. 14; no. 4; pp. 404 - 411
• Main Authors: Bhattarai, Narayan Raj, Van der Auwera, Gert, Khanal, Basudha, De Doncker, Simonne, Rijal, Suman, Das, Murari Lal, Uranw, Surendra, Ostyn, Bart, Praet, Nicolas, Speybroeck, Niko, Picado, Albert, Davies, Clive, Boelaert, Marleen, Dujardin, Jean-Claude
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.04.2009; Blackwell Publishing Ltd; Blackwell
• Subjects: Agglutination Tests; Agglutination Tests - methods; Animals; Antibodies, Protozoan; Antibodies, Protozoan - blood; Antigens, Protozoan; asymptomatic infections; Biological and medical sciences; Biomarkers; Biomarkers - blood; blood; DAT; diagnosis; diagnostic use; DNA, Protozoan; DNA, Protozoan - blood; epidemiology; General aspects; Human protozoal diseases; Humans; infecciones asintomáticas; Infections; infections asymptomatiques; Infectious diseases; isolation & purification; Kala‐azar; Leishmania; Leishmania donovani; Leishmania donovani - isolation & purification; Leishmaniasis, Visceral; Leishmaniasis, Visceral - diagnosis; Leishmaniasis, Visceral - epidemiology; Leshmaniasis; Mass Screening; Mass Screening - methods; Medical diagnosis; Medical sciences; methods; Nepal; Népal; Parasitic diseases; Parasitic protozoa; PCR; Pista; Polymerase Chain Reaction; Polymerase Chain Reaction - methods; Protozoal diseases; prueba de aglutinación directa; visceral leishmaniasis; Nepal; Asia; Human; Kala-azar; Protozoal disease; Healthy subject; Kala azar; Asymptomatic; Leishmaniasis; Parasitosis; Infection; Polymerase chain reaction; asymptomatic infections; DAT; Tropical medicine; Molecular biology; Nepal; PCR
• ISSN: 1360-2276; 1365-3156; 1365-3156
• DOI: 10.1111/j.1365-3156.2009.02242.x

To compare a PCR assay and direct agglutination test (DAT) for the detection of potential markers of Leishmania infection in 231 healthy subjects living in a kala-azar endemic focus of Nepal. The sample was composed of 184 (80%) persons without any known history of KA and not living in the same house as known kala-azar cases (HNK), 24 (10%) Healthy Household Contacts (HHC) and 23 (10%) past kala-azar cases which had been successfully treated (HPK). PCR and DAT positivity scores were, respectively: HNK, 17.6% and 5.6%; HHC, 12.5% and 20.8%; HPK, 26.1% and 95.7%. The ratio PCR-positives/DAT-positives was significantly higher in HNK (ratio = 3.1) than in HHC (ratio = 0.6, P = 0.036) and in HPK (ratio = 0.2, P = 0.012). The ratio PCR-positives/DAT-positives did not significantly differ between HHC (ratio = 0.6) and HPK (ratio = 0.2, P = 0.473). The positive agreement index between PCR and DAT in HNK was 5%; in HHC, 0%; in HPK, 43%. Our study highlights the specific character of PCR and DAT for the exploration of Leishmania asymptomatic infections. PCR is probably more informative for very recent infections among HNK, while DAT provides more information among HHC and HPK, a feature likely related to the power of serology to track less recent infections.