A comparison between molecular and serological methods in the diagnosis of Kala-azar.

number: 
2209
إنجليزية
Degree: 
Imprint: 
Biotechnology
Author: 
Abdulsadah Abdulabbas Rahi Al-Gunima
Supervisor: 
Dr.Ihsan M. Al-Saqur
year: 
2008
Abstract:

Eight hundred blood samples of patients with Kala-azar and one undred blood samples of control group were studied. The number of the notified cases of Kala-azar in Baghdad and Wasit governorates during the period from January 2008 to August 2008 was 800 cases,fluctuated to reach a maximum of 165 cases ( 20.6% ) in January 2008, and declined to reach 49 cases (6.1%) in July 2008. It was also noted that all 300 / 300 (100 %) case -patients had fever, splenomegaly 290/300 (96.7%), hepatomegaly 250 83.3%),weight loss 155 (51.7%), anemia 150 (50%) , paleness 106 ( 35.3% ), diarrhoea 66 ( 22%), leukopenia 50 (16.7%) and abdominal pain 46 ( 15.3% ). The patients were divided according to the age criterion into seven groups from ( G1 < 1year to G7 > 50 years), and the highest infection was appeared in children under one year old 560(70 %). There was male predominance which reached 436 (54.5%) while that female was 364 (45.5%). The proportion of Kala-azar infection in Baghdad (257- 85.7%) was lower than Wasit (460 - 92%). Most of the patients whose number reached 454 (56.8%) lived in different areas of rural Baghdad and Wasit governorates, and under poor conditions 509 (63.6%). Anti-Leishmania antibody was detected in 717(89.62%) by using rK39; and from 100 blood samples ; 95, 70 and 88 were positive by using direct agglutination test ( DAT ), indirect immunofluorescent antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA), respectively. Based on these results, sensitivity and specificity of rK39 and DAT were found to be 89.6% , 95%, 100% and 100%, spectively. The sensitivity of IFAT and ELISA in the diagnosis of Kala-azar was 70% and 88% and their a sensitivity, specificity, a positive predictive value ( PPV ) and negative predictive value(NPV) of 88%,100%,100% and 45.45% respectively. While for rK39 these values were 89.6%,100%,100% and ,respectively.The diagnostic accuracy for ELISA and rK39 was found to be 89.09% and 90.77 %, respectively. Out of 100 patients, 95 appeared to be positive by PCR test and 5 were negative, giving a sensitivity for PCR of 95% and specificity of 100 %. Data analysis was done by Statistical Package for Social Sciences (SPSS) software and by using descriptive and analytical statistics.