Immunochromatographic (rK39) strip test in the diagnosis of visceral leishmaniasis in Bangladesh.

ABSTRACT

Immunochromatographic strip test (ICT strip test) for the diagnosis of visceral leishmaniasis was evaluated in this study in the context of a case-control study. A total sixty consecutive cases of kala-azar admitted in all four Medicine Units of Mymensingh Medical College Hospital during the period of May 2002 to February 2003 was included here. Parasitological confirmation was done by demonstration of leishmania donovani bodies in bone marrow or splenic aspiration in all cases. A total 120 controls was taken of which sixty were asymptomatic endemic controls with no previous history of kala-azar and sixty were admitted patients suffering from diseases other than kala-azar (malaria, tuberculosis, enteric fever and chronic liver disease). ICT strip test for kala-azar was done in all cases and controls. Only 2 of the confirmed kala-azar cases were negative and the remaining 58 cases were positive for ICT strip test which gives the sensitivity of this test 96.6%. Among the controls, 118 were negative for ICT strip test and two of the asymptomatic controls were positive for this test with no clinical evidence of kala-azar. So, the estimated specificity of ICT strip test is 98.3%. The predictive value for a negative result was 98.3% and for a positive result was 96.6%. The ICT strip test is easy, quick, requires no technical facilities with higher sensitivity and specificity entails it to be the ideal test for the diagnosis of kala-azar in field level.