Comparative evaluation of serological tests in Indian kala-azar.

Data on 41 kala-azar patients were collected and the series of serological tests employed to diagnose the disease were compared depending upon their sensitivity and specificity indices. The indirect fluorescent antibody test (IFAT) was found to be 100% sensitive and specific. The direct agglutination test (DAT) involving detection of agglutinating antibodies against Leishmania donovani was 97.2% efficient. The enzyme-linked immunosorbent assay (ELISA) had a specificity of 75% while other tests such as counter-immunoelectrophoresis (CIEP), aldehyde and the Sia water test ranged from 84.3 to 97.2% in efficiency. On the basis of the costs and ease of the tests, the use of DAT along with CIEP is highly recommended for early detection of kala-azar.