Costa L N G, Borba A S, Castagna C L, Carvalho Filho E B, Marson F A L, Sá Junior F F, Angerami R N, Levy C E
Department of Pediatrics,University of Medical Sciences,University of Campinas, SP,Brazil.
Health Surveillance of Municipal Health,Teresina, PI,Brazil.
Epidemiol Infect. 2015 Apr;143(5):1088-95. doi: 10.1017/S0950268814001721. Epub 2014 Jul 14.
SUMMARY Using the polymerase chain reaction (PCR) test for diagnosis of canine leishmaniasis has greater sensitivity and specificity than culture and visualization of the parasite. This study compares PCR for the diagnosis of the genus and species of Leishmania with serological techniques used for the control of canine visceral leishmaniasis (CVL) in Brazil, considering two regions. We analysed peripheral blood samples collected from 195 dogs in the Campinas (SP) and Teresina (PI) regions. ELISA was performed as a serological method and PCR was performed using specific primers for the genus Leishmania spp. and the species Leishmania chagasi. In Campinas, a greater sensitivity of PCR (88.24%) (P = 0.0455) compared to Teresina (14.71%) (P < 0.0001) was observed, and an agreement was observed for Cohen's kappa index (0.9096). Both PCR and ELISA showed discordance for sensitivity (Campinas 100%, Teresina 21.74%), specificity (Campinas 30.77%, Teresina 100%), positive predictive value (Campinas 68.97%, Teresina 100%), negative predictive value (Campinas 100%, Teresina 37.94%) and Cohen's kappa index (0.1238). This study confirms the importance of PCR in analysis of the canine reservoir, and as an effective method for the detection of active and recent infection.
摘要 使用聚合酶链反应（PCR）检测犬利什曼病，其敏感性和特异性高于寄生虫培养和镜检。本研究比较了用于诊断利什曼原虫属和种的PCR与巴西用于控制犬内脏利什曼病（CVL）的血清学技术，研究涉及两个地区。我们分析了从坎皮纳斯（圣保罗州）和特雷西纳（皮奥伊州）地区的195只犬采集的外周血样本。采用ELISA作为血清学方法，使用针对利什曼原虫属和恰加斯利什曼原虫种的特异性引物进行PCR检测。在坎皮纳斯，观察到PCR的敏感性（88.24%）（P = 0.0455）高于特雷西纳（14.71%）（P < 0.0001），并且观察到科恩kappa指数的一致性（0.9096）。PCR和ELISA在敏感性（坎皮纳斯100%，特雷西纳21.74%）、特异性（坎皮纳斯30.77%，特雷西纳100%）、阳性预测值（坎皮纳斯68.97%，特雷西纳100%）、阴性预测值（坎皮纳斯100%，特雷西纳37.94%）和科恩kappa指数（0.1238）方面均显示出不一致性。本研究证实了PCR在分析犬类宿主中的重要性，以及作为检测活动性和近期感染的有效方法的重要性。
