1887

Abstract

Following antigen preparation procedures similar to those of the direct agglutination test (DAT), an IgG ELISA employing intact -mercaptoethanol (-ME)-treated promastigotes was developed. The performance of the -ME ELISA thus developed was assessed in patients with confirmed visceral leishmaniasis (VL), revealing slightly lower sensitivity (39/40=97.5 %) than that of the DAT (40/40=100 %). When challenged with sera of individuals with non-VL conditions, including leukaemia and African trypanosomiasis, the specificity of the -ME ELISA was 100 % (158/158), compared to 98.8 % (156/158) for DAT. In an endemic population (=145) manifesting a clinical suspicion of VL, results obtained with the -ME ELISA were highly concordant with those of DAT, both in the seropositive (65/68=95.6 %) and seronegative (77/80=96.3 %) groups. Furthermore, the incorporated intact antigen demonstrated higher sensitivity in ELISA (16/18=88.9 %) than the water-soluble equivalent (13/18=72.2 %). The stability of the formaldehyde-fixed antigen (2 months at 4 °C) in -ME ELISA, as well as the option for direct testing of whole-blood samples and visual reading of results (within 2 h, compared to 18 h for DAT), advocate the simultaneous application of the technique with DAT for confirmation of VL in laboratories with limited facilities.

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2006-09-01
2024-03-28
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