PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh

Salam, Md. Abdus and Mondal, Dinesh and Kabir, M. and Ekram, A.R.M.S. and Haque, Rashidul (2010) PCR for diagnosis and assessment of cure in kala-azar patients in Bangladesh. Acta Tropica, 113 (1). pp. 52-55. ISSN 0001706X

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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.

Item Type:	Article (Journal)
Additional Information:	9217/87196
Uncontrolled Keywords:	Visceral leishmaniasis Kala-azar Leishmania-nested PCR Leishmania donovani Sodium stibogluconate Cure assessment Bangladesh
Subjects:	R Medicine > RC Internal medicine > RC111 Infectious and Parasitic Diseases
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Basic Medical
Depositing User:	Prof. Dr. Md. Abdus Salam
Date Deposited:	06 Jan 2021 13:58
Last Modified:	06 Jan 2021 13:58
URI:	http://irep.iium.edu.my/id/eprint/87196

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