Leishmaniasis dipstick

Accurate and rapid diagnosis of leishmaniasis is of great importance, i.e. to start early treatment and to prevent transmission, but remains problematic. Clinical diagnosis is difficult due to variable disease symptoms. Parasitological diagnosis relies on microscopical demonstration or culturing of Leishmania parasites from aspirates, but sample retrieval is painful and the microscopic identification in smears and biopsy sections requires experienced personnel and the isolation of parasites by culturing is time-consuming, difficult and expensive. As diagnostic procedures have often to be employed under harsh field conditions, serological tests should, besides having a very good sensitivity and specificity as all diagnostics tests, meet specific requirements like not requiring advanced equipment, electricity or a cold chain.

 At present the direct agglutination tests (DAT and FAST) and the commercially available rK39 dipstick test are partly meeting these requirements, but may either be time consuming (DAT) or there is concern about the sensitivity/specificity of the test (rK39). Therefore, there is still a need for the development of diagnostic test for VL that is suitable for use in peripheral health services (simplicity), has a high sensitivity/specificity and is affordable.