Diagnostic value of rK39 dipstick in zoonotic visceral leishmaniasis in Turkey

Abstract

K39 is a repetitive immunodominant epitope in a kinesin-related protein expressed predominantly in the amastigotes of visceral Leishmania spp. Enzyme immunoassays of patient's sera with recombinant K39 (rK39) proved to be highly specific and sensitive for diagnosis of active visceral leishmaniasis (VL, kala-azar). The same assays in dipstick format were also found effective for diagnosis of both human VL (HVL) and canine VL (CanVL) in most endemic areas of these diseases. Fifty-eight human patients and 22 dogs, clinically suspected of kala-azar, were screened with rK39 dipstick in comparison with the conventional methods of diagnosis, i.e., microscopic examinations of bone marrow and lymph node aspirates and immunofluorescent antibody tests (IFAT), respectively. Sixteen patients and 12 dogs were found to be rK39 dipstick positive. The results were corroborated with those of parasitological examinations, except 1, rK39-positive but smear-negative, case in each group. IFAT of the 2 discordant cases gave positive results. The rK39 dipstick is thus reliable for diagnosis of both HVL and canVL cases in Turkey.