Artículos de revistas
Evaluation of conventional serological tests for the diagnosis of American cutaneous Leishmaniasis
Autor
Añez Reverol, Nestor Oswaldo
Crisante R., Gladys E.
Rojas E., Agustina del V.
Institución
Resumen
Three serological tests (ELISA, IFAT, DAT) were evaluated using sera from selected
individuals with different American cutaneous leishmaniasis (ACL) clinical conditions. Reactivity in
at least 2 of the 3 named tests was established as a criterion for declaring a patient as sero-positive.
Prior to serological testing, people were diagnosed by clinical (presence of lesion = pl or scar=Sc),
parasitological (presence of parasites =pp), immunological (LST) and molecular (PCR) methods. For
a statistical comparison of the evaluated tests 4 groups of people were made up: 1) patients with
active leishmanial lesion (n=44; pl, pp, +LST, +PCR); 2) patients who had recovered from leishmanial
infection (n=43; Sc, +LST, +PCR); 3) asymptomatic individuals from endemic areas showing evidence
of having contacted Leishmania-parasites (n=40; +LST, +PCR) and 4) Leishmania-negative people
from the above localities where leishmaniasis is endemic and living under the same risk conditions,
considered as healthy controls (n=104; -LST, -PCR). Considering the above-established criteria
for sero-positives, the analysis of the results obtained with the 3 tests employed revealed very low
sensitivity values. Seropositive figures of 50% were recorded for the first group, 9% for the second
group, and 12.5% for the third group. Statistical analysis also revealed a low positive predictive value
(PPV=0.73), a low negative predictive value (NPV=0.49), and a low kappa coefficient value (k=0.114).
The present results raise questions about the use of the 3 conventional serological tests compared
here to detect ACL at any clinical condition. 55-62 nanes@ula.ve gecr68@hotmail.com agustinarojas@yahoo.com