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Evaluation of Urine as a Diagnostic Specimen for Visceral Leishmaniasis in Sudan

Emma van Rij, Bakri Y M Nour and Henk D F H Schallig

Diagnostic methods for visceral leishmaniasis (VL) require invasive specimen sampling. Urine is a potential noninvasive alternative and in the present study the diagnostic performance of direct agglutination test (DAT), based on a freeze dried antigen, and rK39 strip test (InBios, Bio-Rad) on specimens collected in Sudan was assessed. RK39 test had a sensitivity of 72.1% and a specificity of 76.9% on urine and DAT sensitivity was 62.8% and its specificity 69.2%, using initial diagnosis (VL diagnosis was confirmed on clinical and serological basis) as reference in both cases. Tests agreements were fair. Both rK39 as well DAT have potential in diagnosing VL using urine, but results are currently not as good as on the Indian sub-continent.