Evaluation of different diagnostic methods of American Cutaneous Leishmaniasis in the Brazilian Amazon

• Autor(a) principal: Espir, Thaís Tibery
• Data de Publicação: 2016
• Outros Autores: Guerreiro, Thayanne Sá, Naiff, Maricleide de Farias, Figueira, Luanda de Paula, Soares, Fabiane Veloso, Silva, Susi Simas da, Franco, A. M.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional do INPA
• Texto Completo: https://repositorio.inpa.gov.br/handle/1/15805
• topic: Immunoglobulin G Antibody; Immunoglobulin M Antibody; Immunoglobulin G; Immunoglobulin M; Protozoon Antibody; Adult; Aged; Brasil; Clinical Controlled Study; Hypersensitivity, Delayed; Enzyme-linked Immunosorbent Assay; Female; Human; Leishmania Amazonensis; Leishmania Guyanensis; Leishmanin Skin Test; Male; Parasite Examination; Parasite Localization; Priority Journal; Sensitivity And Specificity; Skin Leishmaniasis; Species Identification; Tissue Distribution; Blood; Cross-sectional Study; Endemic Disease; Evaluation Study; Hypersensitivity, Delayed; Immunology; Intracutaneous Test; Isolation And Purification; Leishmania Guyanensis; Leishmaniasis, Mucocutaneous; Middle Aged; Parasitology; Young Adult; Adult; Aged; Antibodies, Protozoan; Brasil; Cross-sectional Studies; Endemic Diseases; Enzyme-linked Immunosorbent Assay; Female; Humans; Hypersensitivity, Delayed; Immunoglobulin G; Immunoglobulin M; Intradermal Tests; Leishmania Guyanensis; Leishmaniasis, Mucocutaneous; Male; Middle Aged; Young Adult

Epidemiological studies have been conducted to better understand the dynamics of American Cutaneous Leishmaniasis (ACL) in the Amazon region where distinct species of Leishmania circulate. In endemic areas, the optimal diagnosis must be made in the earlier clinical presentation to avoid the complications of chronic disease. The scarcity of financial support, laboratory infrastructure and trained persons are the major obstacles in this reality. This paper describes the result of performing different diagnostic methods for ACL in Amazonas State between the years 2010 and 2011. The tests used were the intradermal skin test (Montenegro's skin test), ELISA (Enzyme-Linked Immunosorbent Assay), direct examination, culture isolation and identification of Leishmania species. A total of 38 suspected human cases of ACL were diagnosed by different methods, of which 71.0% (n = 27) were positive by direct examination, 75.6% (n = 28) had positivity in the culture isolates and, of these, 54.0% (n = 19) had infection with Leishmania (Viannia) guyanensis. The positivity of the intradermal skin test with the leishmanin solution was observed in 77.0% of cases analyzed and the serology with detection of IgG and IgM showed the presence of antibodies in 100% of exams realized results, showing variation in the titles of antibodies. The success of Leishmaniasis treatment depends on an effective and early diagnosis. Parasitological diagnosis is highly specific, but sensitivity is subject to variation because the tissue distribution of parasites generally is not homogeneous and depends on the specie of parasite. Moreover, parasitological tests require invasive procedures and depend on restrictive conditions for the collection of biological sample, which limit their use in large-scale for epidemiological studies. ELISA has been the most widely used serological method for the diagnosis of Visceral Leishmaniasis (VL) as it is easy to perform and has a low cost. However, flaws in specificity are observed in the diagnosis of cutaneous leishmaniasis. Actually the diagnosis needs to be done as an associated methods depending on the question to be solved. © 2016 Elsevier Inc.