Visceral leishmaniasis (or kala-azar) is caused by a parasite, results
in fever, a large spleen and other health problems, occuring in India,
Bangladesh and Nepal, east Africa, the Mediterranean region and Brazil.
Without treatment people die, and proper treatment can result in cure,
so diagnosis is important. Many of the tests that are used to determine
if a person has visceral leishmaniasis are complicated, costly, painful
and sometimes dangerous for the patients. Now rapid diagnostic tests
that are safe and easy to perform are available.
This Cochrane review describes how accurate these rapid diagnostic tests
are for diagnosing visceral leishmaniasis. We summarize those studies
that evaluated the rapid tests in people who, according to their
physicians, could have the disease. We only included studies in which
the researchers had used established methods to distinguish the people
with visceral leishmaniasis from those who did not have the disease.
We found 24 studies, which contained information about five different
rapid tests. A total of 4271 people participated in these studies. One
of the rapid tests (called the rK39 immunochromatographic test) gave
correct, positive results in 92% of the people with visceral
leishmaniasis and it gave correct, negative results in 92% of the people
who did not have the disease. This test worked better in India and Nepal
than in east Africa. In India and Nepal, it gave correct, positive
results in 97% of the people with the disease. In east Africa, it gave
correct, positive results in only 85% of the people with the disease.
A second rapid test (called latex agglutination test) gave correct,
positive results in 64% of the people with the disease and it gave
correct, negative results in 93% of the people without the disease. For
the other rapid tests evaluated, there are too few studies to know how
accurate they are.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Boelaert, M.; Verdonck, K.; Menten, J.; Sunyoto, T.; van Griensven, J.; Chappuis, F.; Rijal, S. Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease. Cochrane Database of Systematic Reviews (2014) Issue 6, Art. No.: CD009135. [DOI: 10.1002/14651858.CD009135.pub2]
Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease