Sensitivity vs. practicability!
If you are to choose or recommend a test to be use for diagnosis of visceral leishmaniasis in endemic field areas, do you recommend the Direct Agglutination Test (DAT) or rK39 rapid device? Considering the known low sensitivity of rK39-based tests and potential shortcoming of DAT!
What about rK28- rapid tests?
We use DAT, some use rapid test of rk39! What test do you suggest, what is your experience?
DAT and rK39-based test, are specifically developed for field use and are satisfactorily validated. In DAT, stained promastigotes (coomassie brilliant blue) are incubated with the patients’ serum and after overnight incubation agglutination is observed. DAT showed 94.8% sensitivity and 85.9% specificity; however, despite good results, multiple pipetting and a long incubation period are some major disadvantages of this test.
rK39 technique has become quite popular in recent years. A small drop of serum/blood sample is required and results can be obtained within 15 minutes. rK39 test is 100% sensitive and 98% specific (in India).
You must take blood specimen and under field Microscope you can see Leishmania parasites inside white blood cells
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