Mittal V, Bhatia R, Sehgal S
National Reference Centre for Kala-azar, Zoonosis Division, National Institute of Communicable Diseases, Delhi, India.
J Commun Dis. 1991 Jun;23(2):131-4.
The sensitivity and specificity of three serological tests viz. indirect immunofluorescent antibody test (IFAT), enzyme linked immunosorbent assay (ELISA) and counterimmunoelectrophoresis (CIEP) for the diagnosis of Indian kala-azar were evaluated. Of the 209 patients in whom Leishmania donovani parasite could be demonstrated in bone marrow, 207 (99.04 per cent) could be diagnosed with IFAT, 203 (96.6 per cent) with CIEP and 208 (99.5 per cent) with ELISA. None of these serological tests was positive in 40 healthy individuals and 10 patients each with tuberculosis, toxoplasmosis and malaria. In only one out of 10 patients with malaria ELISA alone gave false positive result. Of the 119 patients who had clinical features simulating kala-azar but were negative for Leishmania donovani in bone marrow and responded to treatment other than that for Indian Kala-azar, IFAT, CIEP and ELISA were false positive in three (2.5 per cent), nil and three (2.5 per cent) cases, respectively. The use of serodiagnostic tests like ELISA for mass screening and CIEP in less well equipped peripheral laboratories is suggested.
评估了三种血清学检测方法，即间接免疫荧光抗体试验（IFAT）、酶联免疫吸附测定（ELISA）和对流免疫电泳（CIEP）用于诊断印度黑热病的敏感性和特异性。在209例骨髓中可检出杜氏利什曼原虫的患者中，207例（99.04%）可通过IFAT诊断，203例（96.6%）可通过CIEP诊断，208例（99.5%）可通过ELISA诊断。在40名健康个体以及各10名患有结核病、弓形虫病和疟疾的患者中，这些血清学检测均未呈阳性。仅10例疟疾患者中有1例ELISA单独出现假阳性结果。在119例具有类似黑热病临床特征但骨髓中杜氏利什曼原虫检测呈阴性且对非印度黑热病治疗有反应的患者中，IFAT、CIEP和ELISA分别在3例（2.5%）、0例和3例（2.5%）中出现假阳性。建议使用ELISA等血清学诊断检测方法进行大规模筛查，并在设备较差的基层实验室使用CIEP。
