Sensitivity and specificity of parallel or serial serological testing for
detection of canine Leishmania infection |
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Authors: | Mauro Maciel de Arruda Fabiano Borges Figueiredo Andreza Pain Marcelino José Ronaldo Barbosa Guilherme Loureiro Werneck Elza Ferreira Noronha Gustavo Adolfo Sierra Romero |
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Institution: | 1.Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brasil;2.Fundação Oswaldo Cruz, Instituto de Pesquisa Clínica Evandro Chagas, Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Rio de Janeiro, RJ, Brasil;3.Fundação Ezequiel Dias, Belo Horizonte, MG, Brasil;4.Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil |
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Abstract: | In Brazil, human and canine visceral leishmaniasis (CVL) caused byLeishmania
infantum has undergone urbanisation since 1980, constituting a public
health problem, and serological tests are tools of choice for identifying infected
dogs. Until recently, the Brazilian zoonoses control program recommended
enzyme-linked immunosorbent assays (ELISA) and indirect immunofluorescence assays
(IFA) as the screening and confirmatory methods, respectively, for the detection of
canine infection. The purpose of this study was to estimate the accuracy of ELISA and
IFA in parallel or serial combinations. The reference standard comprised the results
of direct visualisation of parasites in histological sections, immunohistochemical
test, or isolation of the parasite in culture. Samples from 98 cases and 1,327
noncases were included. Individually, both tests presented sensitivity of 91.8% and
90.8%, and specificity of 83.4 and 53.4%, for the ELISA and IFA, respectively. When
tests were used in parallel combination, sensitivity attained 99.2%, while
specificity dropped to 44.8%. When used in serial combination (ELISA followed by
IFA), decreased sensitivity (83.3%) and increased specificity (92.5%) were observed.
Serial testing approach improved specificity with moderate loss in sensitivity. This
strategy could partially fulfill the needs of public health and dog owners for a more
accurate diagnosis of CVL. |
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Keywords: | dogs sensitivity specificity visceral leishmaniasis Leishmania infantum serology |
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