Arana B A, Roca M, Rizzo N R, Mendoza C E, Kroeger A
Centre for Health Studies, Universidad del Valle de Guatemala, Guatemala.
Trans R Soc Trop Med Hyg. 1999 Jul-Aug;93(4):394-6. doi: 10.1016/s0035-9203(99)90129-3.
Before recommending the skin-test use at national level in Guatemala of an antigen prepared from Leishmania major (a Leishmania species not found in the New World), we conducted a study in 100 Guatemalans to determine its sensitivity and specificity. The antigen consisted of 0.1 mL of a solution that contained 5 x 10(6) promastigotes of L. major (MRHO/IR/75/VAX). Positive leishmanin skin test (LST) reactions at 48 h were observed in 16 (80%) of 20 patients with proven active cutaneous leishmaniasis (CL), 18 (90%) of 20 with previously treated proven CL, and in 18 (90%) of 20 with a history and compatible scan of previously suspected but unconfirmed CL. None of 20 healthy controls or 20 patients with skin lesions due to causes other than CL had positive reactions to the LST, giving a sensitivity of 85% and specificity of 100%. There were no statistically significant differences in ethnic group, age, duration of the lesion, lesion size or Leishmania species between the 34 persons with true positive reactions. Even though it will be necessary to test this antigen on a larger number of patients, these preliminary results show that this antigen is specific and reasonably sensitive in identifying current or past CL and that it is a reasonable choice for epidemiological studies on CL in Guatemala.
在建议在危地马拉全国范围内使用由硕大利什曼原虫（新世界未发现的一种利什曼原虫）制备的抗原进行皮肤试验之前，我们对100名危地马拉人进行了一项研究，以确定其敏感性和特异性。该抗原由0.1 mL含有5×10⁶ 硕大利什曼原虫（MRHO/IR/75/VAX）前鞭毛体的溶液组成。在20例经证实的活动性皮肤利什曼病（CL）患者中，16例（80%）在48小时时利什曼菌素皮肤试验（LST）呈阳性反应；20例既往经治疗证实的CL患者中，18例（90%）呈阳性反应；20例有既往疑似但未经证实的CL病史且扫描结果相符的患者中，18例（90%）呈阳性反应。20名健康对照者或20例由CL以外原因引起皮肤病变的患者中，无人对LST呈阳性反应，敏感性为85%，特异性为100%。34例真阳性反应者在种族、年龄、病变持续时间、病变大小或利什曼原虫种类方面无统计学显著差异。尽管有必要在更多患者身上测试该抗原，但这些初步结果表明，该抗原在识别当前或既往CL方面具有特异性且相当敏感，是危地马拉CL流行病学研究的合理选择。
