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Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance

Background: several tests are performed to obtain better accuracy when diagnosing American tegumentary leishmaniasis (ATL). It is believed that antigens released via secretion, excretion and metabolism are more specific than are antigens released by the lysis of Leishmaniaparasites. Such antigens ar...

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Main Authors: Soares, Killarney Ataide, Urdapilleta, Ada Amália Ayala, Santos, Gilcilene Maria dos, Carneiro, Andréa Lisboa, Gomes, Ciro Martins, Roselino, Ana Maria, Sampaio, Raimunda Nonata Ribeiro
Format: Artigo
Language: English
Published: Brazilian Society of Infectious Diseases 2017
Subjects:
Diagnóstico
Controle de doenças
Doenças infecciosas
Leishmaniose
Online Access: http://repositorio.unb.br/handle/10482/29786
http://dx.doi.org/10.1016/j.bjid.2015.03.010
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spelling ir-10482-297862019-03-28T14:08:40Z Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance Soares, Killarney Ataide Urdapilleta, Ada Amália Ayala Santos, Gilcilene Maria dos Carneiro, Andréa Lisboa Gomes, Ciro Martins Roselino, Ana Maria Sampaio, Raimunda Nonata Ribeiro Diagnóstico Controle de doenças Doenças infecciosas Leishmaniose Background: several tests are performed to obtain better accuracy when diagnosing American tegumentary leishmaniasis (ATL). It is believed that antigens released via secretion, excretion and metabolism are more specific than are antigens released by the lysis of Leishmaniaparasites. Such antigens are known as exo-antigens (exo-Ag) and are formed from products released by cultured parasites in a way that is similar to that in which they cause infections in hosts. Objective: we attempted to validate a Leishmania mexicanaELISA exo-Ag for ATL diagnosis in Midwestern Brazil. Methods: a total of 281 patients were included in the study. We analysed pre-treatment blood from 98 ATL patients; out of those, 85.7% and 14.3% had cutaneous and mucosal forms, respectively. Results: the exo-Ag accuracy was 83.99% (95% CI = 79.24-87.81) with a sensitivity value of 90.82% (95% CI = 83.46-95.09) and an overall specificity value of 80.33% (95% CI = 73.97-85.44). The positive predictive value and negative predictive value were 71.20% (95% CI = 62.72-78.41) and 94.23% (95% CI = 89.40-96.94), respectively. Among healthy controls, exo-Ag had a specificity of 91.25% (95% CI = 83.02-95.70); additionally, the test had specificity rates of 66.67% (95% CI = 46.71-82.03) in Chagas disease patients, 60.61% (95% CI = 43.68-75.32) in patients with rheumatic diseases, 76.92% (95% CI = 49.74-91.82) in pemphigus foliaceus patients, 87.50% (95% CI = 52.91-97.76) in leprosy patients, 87.50% (95% CI = 63.98-96.50) in VRDL-positive patients, and 77.78 (95% CI = 45.26-93.68) in deep mycosis patients. Conclusion: based on the indicators of validity, we conclude that the results obtained in this study enable the recommendation of the exo-Ag ELISA for ATL diagnosis once it presented a reasonable accuracy compared to classical methods. Cost evaluations are necessary to completely define the role of this technique in large scale. 2017-12-07T05:13:15Z 2017-12-07T05:13:15Z 2015-05 Artigo SOARES, Killarney Ataide et al. Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance. Brazilian Journal of Infectious Diseases, Salvador, v. 19, n. 3, p. 302-307, maio/jun. 2015. Disponível em: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702015000300302&lng=en&nrm=iso>. Acesso em: 5 abr. 2018. doi: http://dx.doi.org/10.1016/j.bjid.2015.03.010. http://repositorio.unb.br/handle/10482/29786 http://dx.doi.org/10.1016/j.bjid.2015.03.010 en Acesso Aberto Brazilian Journal of Infectious Diseases - This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY NC ND 4.0). Fonte: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702015000300302&lng=en&nrm=iso. Acesso em: 5 abr. 2018. application/pdf Brazilian Society of Infectious Diseases
institution REPOSITORIO UNB
collection REPOSITORIO UNB
language English
topic Diagnóstico
Controle de doenças
Doenças infecciosas
Leishmaniose
spellingShingle Diagnóstico
Controle de doenças
Doenças infecciosas
Leishmaniose
Soares, Killarney Ataide
Urdapilleta, Ada Amália Ayala
Santos, Gilcilene Maria dos
Carneiro, Andréa Lisboa
Gomes, Ciro Martins
Roselino, Ana Maria
Sampaio, Raimunda Nonata Ribeiro
Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
description Background: several tests are performed to obtain better accuracy when diagnosing American tegumentary leishmaniasis (ATL). It is believed that antigens released via secretion, excretion and metabolism are more specific than are antigens released by the lysis of Leishmaniaparasites. Such antigens are known as exo-antigens (exo-Ag) and are formed from products released by cultured parasites in a way that is similar to that in which they cause infections in hosts. Objective: we attempted to validate a Leishmania mexicanaELISA exo-Ag for ATL diagnosis in Midwestern Brazil. Methods: a total of 281 patients were included in the study. We analysed pre-treatment blood from 98 ATL patients; out of those, 85.7% and 14.3% had cutaneous and mucosal forms, respectively. Results: the exo-Ag accuracy was 83.99% (95% CI = 79.24-87.81) with a sensitivity value of 90.82% (95% CI = 83.46-95.09) and an overall specificity value of 80.33% (95% CI = 73.97-85.44). The positive predictive value and negative predictive value were 71.20% (95% CI = 62.72-78.41) and 94.23% (95% CI = 89.40-96.94), respectively. Among healthy controls, exo-Ag had a specificity of 91.25% (95% CI = 83.02-95.70); additionally, the test had specificity rates of 66.67% (95% CI = 46.71-82.03) in Chagas disease patients, 60.61% (95% CI = 43.68-75.32) in patients with rheumatic diseases, 76.92% (95% CI = 49.74-91.82) in pemphigus foliaceus patients, 87.50% (95% CI = 52.91-97.76) in leprosy patients, 87.50% (95% CI = 63.98-96.50) in VRDL-positive patients, and 77.78 (95% CI = 45.26-93.68) in deep mycosis patients. Conclusion: based on the indicators of validity, we conclude that the results obtained in this study enable the recommendation of the exo-Ag ELISA for ATL diagnosis once it presented a reasonable accuracy compared to classical methods. Cost evaluations are necessary to completely define the role of this technique in large scale.
format Artigo
author Soares, Killarney Ataide
Urdapilleta, Ada Amália Ayala
Santos, Gilcilene Maria dos
Carneiro, Andréa Lisboa
Gomes, Ciro Martins
Roselino, Ana Maria
Sampaio, Raimunda Nonata Ribeiro
author_sort Soares, Killarney Ataide
title Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
title_short Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
title_full Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
title_fullStr Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
title_full_unstemmed Field validation of a Leishmania (Leishmania) mexicana exo-antigens ELISA for diagnosing tegumentary leishmaniasis in regions of Leishmania (Viannia) predominance
title_sort field validation of a leishmania (leishmania) mexicana exo-antigens elisa for diagnosing tegumentary leishmaniasis in regions of leishmania (viannia) predominance
publisher Brazilian Society of Infectious Diseases
publishDate 2017
url http://repositorio.unb.br/handle/10482/29786
http://dx.doi.org/10.1016/j.bjid.2015.03.010
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score 13.657419

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