Rapid Non-Invasive Diagnosis of Kala-azar

Abstract

Background: Kala-azar is endemic throughout central and eastern terai region of Nepal bordering the Indian state of Bihar. Lack of knowledge, unavailable simple and reliable diagnostic test and poverty-all contribute to late diagnosis and institution of an effective chemotherapy; thereby maintaining the potential human reservoir at high level in the community. Since invasive diagnostic method is an unacceptable test of choice in the endemic region, an alternative technique is a dire necessity. The present study evaluated recombinant K-39 Leishmania test with splenic aspirate in hospitalized Kala-azar patients. Methods: This was a retrospective review of hospital case record of Kala-azar patients admitted during the months of Poush- Chaitra 2057. All hospital case notes of the 4 months with the diagnosis of Kala-azar were screened. Shukraraj Tropical and Infectious Disease Hospital, Teku was taken as the study area. Results: The rK-39 Leishmania dipstick achieved a high sensitivity (96%) and high positive value (95%). The dipstick is a simple, reliable and a robust technique. Conclusions: The rK-39 Leishmania dipstick is an acceptable test of choice in the diagnosis of Kala-azar and may be of great utility especially in the endemic districts where invasive methods are neither applicable nor appropriate. Keywords: endemic; Kala-azar; positive predictive value; rK-39 Leishmania dipstick; sensitivity.