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PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh.
Acta Trop. 2010 Jan; 113(1):52-5.AT

Abstract

The study evaluated the usefulness of Leishmania-nested polymerase chain reaction (Ln-PCR) for diagnosis of kala-azar and assessed its role as a test of cure among kala-azar patients in Bangladesh. Peripheral blood buffy coat Ln-PCR was done in ninety-seven (97) clinically suspected patients of kala-azar, in forty (40) healthy controls from both endemic and non-endemic areas, and in forty-six (46) patients after completion of treatment with sodium stibogluconate (SSG). The Ln-PCR results were compared with Leishmania donovani parasite load graded by 1+ to 6+ in all smear-positive L. donovani cases. Out of 97 clinically suspected kala-azar patients, 94 were parasitologically confirmed. Ln-PCR was found positive in 91 of 94 parasitologically positive patients of kala-azar at diagnosis, indicating its diagnostic sensitivity as 97%. None of the controls was found positive for Ln-PCR, indicating its diagnostic specificity to be 100%. About 9% of kala-azar patients having been graded 1+ parasitic load had negative Ln-PCR results. After completion of treatment, Ln-PCR was positive in 4 patients (8.4%) out of 46 cases, indicating its role in demonstrating the absence of parasites 30 days after completion of treatment in 91.6% of the treated patients. This limited study suggests that Ln-PCR is a highly sensitive and specific test for the diagnosis of visceral leishmaniasis and can be used as a test of cure. Thus, efforts should be made to establish this useful method at least in the tertiary care hospitals and, if possible, at the district-level hospitals, especially in the endemic areas of Bangladesh.

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Authors+Show Affiliations

Salam MA
Department of Microbiology, Rajshahi Medical College, Rajshahi, Bangladesh.
Mondal D
No affiliation info available
Kabir M
No affiliation info available
Ekram AR
No affiliation info available
Haque R
No affiliation info available

MeSH

AdolescentAdultAntimony Sodium GluconateAntiprotozoal AgentsBangladeshFemaleHumansLeishmaniaLeishmaniasis, VisceralLeukocytesMalePolymerase Chain ReactionSensitivity and Specificity

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19769932

Citation

Salam, M A., et al. "PCR for Diagnosis and Assessment of Cure in Kala-azar Patients in Bangladesh." Acta Tropica, vol. 113, no. 1, 2010, pp. 52-5.
Salam MA, Mondal D, Kabir M, et al. PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh. Acta Trop. 2010;113(1):52-5.
Salam, M. A., Mondal, D., Kabir, M., Ekram, A. R., & Haque, R. (2010). PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh. Acta Tropica, 113(1), 52-5. https://doi.org/10.1016/j.actatropica.2009.09.005
Salam MA, et al. PCR for Diagnosis and Assessment of Cure in Kala-azar Patients in Bangladesh. Acta Trop. 2010;113(1):52-5. PubMed PMID: 19769932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh. AU - Salam,M A, AU - Mondal,D, AU - Kabir,M, AU - Ekram,A R M S, AU - Haque,R, Y1 - 2009/09/19/ PY - 2009/02/02/received PY - 2009/08/16/revised PY - 2009/09/12/accepted PY - 2009/9/23/entrez PY - 2009/9/23/pubmed PY - 2010/2/23/medline SP - 52 EP - 5 JF - Acta tropica JO - Acta Trop VL - 113 IS - 1 N2 - The study evaluated the usefulness of Leishmania-nested polymerase chain reaction (Ln-PCR) for diagnosis of kala-azar and assessed its role as a test of cure among kala-azar patients in Bangladesh. Peripheral blood buffy coat Ln-PCR was done in ninety-seven (97) clinically suspected patients of kala-azar, in forty (40) healthy controls from both endemic and non-endemic areas, and in forty-six (46) patients after completion of treatment with sodium stibogluconate (SSG). The Ln-PCR results were compared with Leishmania donovani parasite load graded by 1+ to 6+ in all smear-positive L. donovani cases. Out of 97 clinically suspected kala-azar patients, 94 were parasitologically confirmed. Ln-PCR was found positive in 91 of 94 parasitologically positive patients of kala-azar at diagnosis, indicating its diagnostic sensitivity as 97%. None of the controls was found positive for Ln-PCR, indicating its diagnostic specificity to be 100%. About 9% of kala-azar patients having been graded 1+ parasitic load had negative Ln-PCR results. After completion of treatment, Ln-PCR was positive in 4 patients (8.4%) out of 46 cases, indicating its role in demonstrating the absence of parasites 30 days after completion of treatment in 91.6% of the treated patients. This limited study suggests that Ln-PCR is a highly sensitive and specific test for the diagnosis of visceral leishmaniasis and can be used as a test of cure. Thus, efforts should be made to establish this useful method at least in the tertiary care hospitals and, if possible, at the district-level hospitals, especially in the endemic areas of Bangladesh. SN - 1873-6254 UR - https://www.unboundmedicine.com/medline/citation/19769932/PCR_for_diagnosis_and_assessment_of_cure_in_kala_azar_patients_in_Bangladesh_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0001-706X(09)00286-1 DB - PRIME DP - Unbound Medicine ER -