Leishmania Infection: Laboratory Diagnosing in the Absence of a "Gold Standard"

There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the high...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2010-02, Vol.82 (2), p.251-256
Main Authors: Rodriguez-Cortes, Alheli, Ojeda, Ana, Francino, Olga, Lopez-Fuertes, Laura, Timon, Marcos, Alberola, Jordi
Format: Article
Language:English
Subjects:
Animals
Antibodies, Protozoan - blood
Biological and medical sciences
Bone Marrow - parasitology
Cell Proliferation
Dogs
Enzyme-Linked Immunosorbent Assay - methods
Female
Fluorescent Antibody Technique, Indirect - methods
Human protozoal diseases
Immunoglobulins
Infectious diseases
Leishmania - immunology
Leishmaniasis - diagnosis
Leishmaniasis - immunology
Leshmaniasis
Lymphocytes - physiology
Medical sciences
Parasitic diseases
Protozoal diseases
Reverse Transcriptase Polymerase Chain Reaction - methods
Sensitivity and Specificity
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.2010.09-0366