{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T10:46:11Z","timestamp":1792752371392,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,8,16]],"date-time":"2012-08-16T00:00:00Z","timestamp":1345075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> To estimate the sensitivities and specificities of different diagnostic tests for visceral leishmaniasis (VL) using latent class analysis (LCA).<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> This study was performed using data from a prospective study conducted in four Brazilian states from May 2004 to May 2007. Five diagnostic tests for VL were evaluated in 285 VL cases and 119 non\u2010cases: microscopy, indirect fluorescence antibody test (IFAT), enzyme\u2010linked immunosorbent assay using recombinant K39 antigen (rK39\u2010ELISA), direct agglutination test (DAT) and the rK39 rapid test.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Microscopy showed sensitivity of 77.0% (CI: 71.5\u201381.5) and specificity of 99.0% (CI: 94.0\u201399.7). The IFAT and the DAT showed similar sensitivities, 88.3% (CI: 84.0\u201392.0) and 88.5% (CI: 84.1\u201392.0), respectively, but the DAT had a higher specificity (95.4%, CI: 89.2\u201398.1) than did the IFAT (83.0%, CI: 75.0\u201388.2). The rK39\u2010ELISA and the rK39 rapid test showed sensitivities of 99.0% (CI: 96.3\u201399.6) and 94.0% (CI: 90.1\u201396.3), and specificities of 82.5% (CI: 75.0\u201388.3) and 100% (CI: 97.0\u2013100.0%), respectively.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Considering the lack of an adequate reference standard, LCA proved to be a useful tool in validating diagnostic methods for VL. The DAT and the rK39 rapid test showed better performance. Thus, clinically suspected cases of VL in a Brazilian endemic area could be treated based on the positivity of one of these tests.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2012.03064.x","type":"journal-article","created":{"date-parts":[[2012,8,16]],"date-time":"2012-08-16T07:28:07Z","timestamp":1345102087000},"page":"1202-1207","source":"Crossref","is-referenced-by-count":27,"title":["Latent class analysis of diagnostic tests for visceral leishmaniasis in Brazil"],"prefix":"10.1111","volume":"17","author":[{"given":"T\u00e1lia Santana","family":"Machado de Assis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Rabello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Loureiro","family":"Werneck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0037-86822008000600012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.1999.00421.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2004.70.72"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1766"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.09.003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.4269\/ajtmh.2003.68.321","article-title":"Performance of recombinant K39 antigen in diagnosis of brazilian visceral leishmaniasis","volume":"68","author":"Carvalho SFG","year":"2003","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"key":"e_1_2_6_8_1","first-page":"14","article-title":"Estimating diagnostic accuracy of tests for latent tuberculosis infection without a gold standard among healthcare workers","volume":"29","author":"Girardi E","year":"2009","journal-title":"European Surveillance"},{"key":"e_1_2_6_9_1","first-page":"587","article-title":"A framework for clinical evaluation of diagnostic technologies","volume":"134","author":"Guyatt GH","year":"1986","journal-title":"Canadian Medical Association Journal"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9876.00131"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2530508"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.4269\/ajtmh.2009.80.435","article-title":"Sensitivities and specificities of diagnostic tests and infection prevalence of Schistosoma haematobium estimated from data on adults in villages northwest of Accra, Ghana","volume":"80","author":"Koukounari A","year":"2009","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702002000400005"},{"key":"e_1_2_6_14_1","first-page":"105","article-title":"Valida\u00e7\u00e3o do teste imunocromatogr\u00e1fico r\u00e1pido IT\u2010LEISH para o diagn\u00f3stico da leishmaniose visceral humana","volume":"17","author":"Machado de Assis TS","year":"2008","journal-title":"Revista Epidemiologia e Servi\u00e7os de Sa\u00fade"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2010.09.004"},{"key":"e_1_2_6_16_1","volume-title":"Secretaria de Vigil\u00e2ncia em Sa\u00fade, Brasil","author":"Minist\u00e9rio da Sa\u00fade","year":"2006"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2009.04.007"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.11.004"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1568"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5877(01)00272-0"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197810262991705"},{"key":"e_1_2_6_22_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1001\/jama.1995.03530080061042","article-title":"Use of methodological standards in diagnostic test research. 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