Evaluation of Two rK39 Dipstick Tests, Direct Agglutination Test, and Indirect Fluorescent Antibody Test for Diagnosis of Visceral Leishmaniasis in a New Epidemic Site in Highland Ethiopia

We assessed the performance characteristics of two rK39 immunochromatographic tests, a direct agglutination test (DAT), and an indirect immunofluorescent antibody test (IFAT) in the site of a new epidemic of visceral leishmaniasis (VL) in northwestern Ethiopia The study population was composed of 179 patients with suspected VL and 67 controls The sensitivities of Kalazar Detect (R), DiaMed IT Leish (R) DAT, and IFAT in 35 polymerase chain reaction con firmed VL cases were 94 3%, 91 4%, 91 4% and 100%, respectively, and the specificities were 98 5%, 94%, 98 5%, and 98 5%, respectively In a Bayesian latent class analysis of all 246 specimens, the estimated sensitivities were 90 5%, 89%, 88 8%, and 96% for Kalazar Detect (R) DiaMed-IT Leish (R), DAT, and IFAT, respectively, DAT showed the highest estimated specificity (97 4%) Both rK39 immunochromatographic tests perform as well as DAT, and are suitable for VL diagnosis in first level health centers in this area of Ethiopia