Bone marrow smear VS Blood smear in diagnosis of Kala-azar

ABSTRACT

Background  and Objectives:  Bone marrow specimen is considered as superior to the blood in the laboratory diagnosis of Kala-azar. The  main objective of this study is to compare these two methods of diagnosis and determine the usefulness of the diagnostic techniques.Material and Methods:  This  prospective  cross sectional  study  was  conducted at Janakpur Zonal Hospital, Janakpur which was  aimed  to  determine  the usefulness of the bone marrow specimen and blood specimen in the  laboratory diagnosis of Kala-azar. Bone marrow aspirate and venous blood  was  collected  aseptically  from  the  cases  were  processed  simultaneously.  The  results  of these two cultures were compared. Results:  Total 60 cases  of Kala-azar were included in the study of which 32 were male  and 28 were  female.   Amastigote  form  of  Leishmania  donovani  were  detected  in  56  (93.33%)  samples with  high  titre  of  parasitemiae  and  119  (18%)  in  the  blood  sample  with  low  parasitemiae. Sensitivity and Specificity of the test was calculated of the bone marrow sample test have more sensitivity (98%) and specificity (100%) over the sensitivity (90%) and specificity (96%) of blood smear test.Conclusion:  Bone marrow specimens were  found to be more useful than the blood sample in the  laboratory diagnosis of Kala-azar.