Basic and applied research for early diagnosis and early treatment of visceral leishmaniasis

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The aim of this study was to develop simple diagnostic tools for visceral leishmaniasis (VL) using urine samples for early diagnosis and early treatment of the disease.(1) Production of recombinant antigen, rKRP42, for urine diagnosisA DNA fragment coding a part of kinesine related protein, rKRP42 (Accession number : AB256033), was cloned from Leishmania donovani genome and a recombinant protein rKRP42 was obtained from the expression induced E.coli cells. Specificity of the urine ELISA was improved with the recombinant antigen, which is constantly supplied with constant quality.(2) Development of a simple diagnostic tool for VLWe developed a simple method for diagnosis of VL. It detects antibodies in urine samples with anti-human IgG coated plate and colored L.donovani promastigote. Its sensitivity and specificity is almost same as urine ELISA. As this method doesn't need any equipment and the results can be judged by naked eyes, it is suitable to be used in endemic areas where no fac … More ilities is available.(3) Application of the urine ELISA for early diagnosisAmong four villages surveyed in 2003, a village, Nobai Bot Tala, was selected for our survey because of its high positive rate. Fifteen subjects became kala azar during one year from March 2005. Among them, 13 subjects had been examined as positive with urine ELISA before their onset of the symptoms. Therefore, the urine ELISA was suggested as a good tool for early diagnosis of kala azar and this prevent severe illness caused by delayed treatment.(4) Survey of a vector, Phlebotomus speciesP.argentipes which is know as a vector of VL was found at the village by preliminary survey conducted in July 2005. Seventy-one sandflies were trapped in March 2006 and 80% of them were found to be P.argentipes. The sandflies were trapped at 10 out of 12 points surveyed, showing its wide distribution in the village.(5) Mapping of houses in Nobai Bot TalaUsing a handheld device of GPS and satellite image served by Google Earth, all houses in the village were identified and numbered on the satellite image. Analysis for generation status of VL in the village for these years is now going on. Less