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Diagnosis of visceral leishmaniasis: developments over the last decade

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Abstract

Diagnostic parameters for visceral leishmaniasis (VL), a potentially fatal parasitic disease caused by Leishmania donovani, have been redefined in the last decade with the development of serological and molecular tests, though a definitive diagnosis still banks on the century-old parasitological methods in many areas. Recombinant antigens have improved performance of serodiagnostic methods. Serology-based tests, rk39 antigen dipstick, and direct agglutination test commonly employed in the field are highly sensitive methods, however, fail to distinguish past infections. Molecular approaches have become increasingly relevant due to remarkable sensitivity, specificity, and flexibility in choice of samples. Quantitative polymerase chain reaction is a highly sensitive and specific tool used in referral labs for detection/assessment of parasite load in VL patients and subsequently in monitoring treatment response to antileishmanial agents. The method displays potential to provide threshold for distinguishing asymptomatics in endemic areas. Currently, improvement in VL diagnostics is required for successful decentralized (point-of-care) testing in field conditions and to detect VL–HIV co-infection. Techniques such as loop-mediated isothermal amplification offer a reliable molecular diagnostic method for field application. The diagnosis based on bioanalytics/biosensors promise frontiers for point-of-care VL detection after adequate standardization. This review summarizes the recent developments in VL diagnostics, drawing attention towards the need for standardization of the diagnostics across the affected regions.

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Acknowledgments

Financial support by the Indian Council for Medical Research (ICMR) is gratefully acknowledged. S.G and A.K thank the Council for Scientific and Industrial Research for fellowship.

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Authors and Affiliations

  1. Molecular Biology Laboratory, National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029, India

    Gurumurthy Srividya, Arpita Kulshrestha & Poonam Salotra

  2. Molecular Parasitology Laboratory, National Institute of Malaria Research (ICMR), Institutional Area, Sector-8, Dwarka, New Delhi, 110077, India

    Ruchi Singh

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  1. Gurumurthy Srividya
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  2. Arpita Kulshrestha
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  3. Ruchi Singh
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  4. Poonam Salotra
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Correspondence to Poonam Salotra.

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Gurumurthy Srividya and Arpita Kulshrestha contributed equally.

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Srividya, G., Kulshrestha, A., Singh, R. et al. Diagnosis of visceral leishmaniasis: developments over the last decade. Parasitol Res 110, 1065–1078 (2012). https://doi.org/10.1007/s00436-011-2680-1

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