Related Experiment Video
Updated: Dec 2, 2025
06:57
In Vivo Infection with Leishmania amazonensis to Evaluate Parasite Virulence in Mice
Published on: February 20, 2020
8.6K
Evidence-based diagnostic algorithm for visceral leishmaniasis in Bangladesh
Md Abdus Salam1, M Mamun Huda2, Md Gulam Musawwir Khan3
1Department of Microbiology, Rajshahi Medical College, Rajshahi 6000, Bangladesh.
Parasitology International
|November 4, 2020
Summary
A new diagnostic algorithm for visceral leishmaniasis (VL) in Bangladesh recommends rK39 rapid diagnostic tests (RDT) for primary care. Buffy coat microscopy is suggested for secondary/tertiary facilities, with PCR/LAMP as tertiary confirmation options.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Diagnostic Technologies
Background:
- Visceral leishmaniasis (VL) diagnosis requires effective tools, especially in resource-limited settings like Bangladesh.
- Existing diagnostic methods vary in accuracy and accessibility, necessitating an evidence-based approach.
- A validated diagnostic algorithm is crucial for timely and accurate VL case management.
Purpose of the Study:
- To evaluate and compare the performance of various diagnostic tools for visceral leishmaniasis (VL) in Bangladesh.
- To develop and propose an evidence-based diagnostic algorithm for VL tailored to different healthcare facility levels.
- To identify the most accurate and accessible diagnostic tools for VL detection.
Main Methods:
- A cross-sectional study involving 100 confirmed VL cases and 100 controls in Bangladesh.
- Evaluation of diagnostic tools including serology (ELISA, RDT), microscopy (buffy coat smear), and DNA-based techniques (PCR, LAMP).
- Performance assessment against spleen smear (gold standard) using kappa coefficient and factor analysis for index scoring (IS).
Main Results:
- All evaluated diagnostic tools showed high agreement (kappa ≥ 0.80) with the gold standard.
- rK39 rapid diagnostic test (RDT) demonstrated the highest performance (IS: 1.7), followed by rK28 RDT (IS: 1.5) and buffy coat smear microscopy (IS: 0.5).
- rK39 RDT is proposed for primary care, buffy coat smear microscopy for secondary/tertiary confirmation, and ssuRNA-PCR or LAMP for tertiary-level confirmation.
Conclusions:
- The rK39 RDT is the most suitable diagnostic tool for primary healthcare facilities in Bangladesh for visceral leishmaniasis.
- Buffy coat smear microscopy serves as a valuable adjunct for confirming serology-positive cases in secondary and tertiary settings.
- Molecular techniques like ssuRNA-PCR and LAMP are viable alternatives for confirmation exclusively at tertiary healthcare facilities.
