{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:55:04Z","timestamp":1776174904379,"version":"3.50.1"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,5,1]]},"abstract":"<jats:p>In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis\u2013endemic focus is the combined use of the direct agglutination test and the leishmanin skin test.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.11-0196","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T21:41:15Z","timestamp":1335994875000},"page":"792-798","source":"Crossref","is-referenced-by-count":37,"title":["Usefulness of the rK39-Immunochromatographic Test, Direct Agglutination Test, and Leishmanin Skin Test for Detecting Asymptomatic Leishmania Infection in Children in a New Visceral Leishmaniasis Focus in Amhara State, Ethiopia"],"prefix":"10.4269","volume":"86","author":[{"given":"Endalamaw","family":"Gadisa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estefan\u00eda","family":"Custodio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Ca\u00f1avate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Sordo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zelalem","family":"Abebe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Nieto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Chicharro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham","family":"Aseffa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Yamuah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Engers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Israel","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Comp Immunol Microbiol Infect Dis","first-page":"305","article-title":"Leishmaniasis: current situation and new perspectives","volume":"27","author":"Desjeux","year":"2004"},{"key":"R2","series-title":"Nat Rev Microbiol","first-page":"873","article-title":"Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?","volume":"5","author":"Chappuis","year":"2007"},{"key":"R3","series-title":"BMJ","first-page":"176","article-title":"The world's most neglected diseases","volume":"325","author":"Yamey","year":"2002"},{"key":"R4","series-title":"Trends Parasitol","first-page":"4","article-title":"Risk factors in the spread of leishmaniases: towards integrated monitoring?","volume":"22","author":"Dujardin","year":"2006"},{"key":"R5","series-title":"Clin Infect Dis","first-page":"684","article-title":"Human leishmaniasis: clinical, diagnostic and chemotherapeutic developments in the last 10 years","volume":"24","author":"Berman","year":"1997"},{"key":"R6","series-title":"Am J Trop Med Hyg","first-page":"373","article-title":"Natural history of a visceral leishmaniasis outbreak in Highland Ethiopia","volume":"81","author":"Herrero","year":"2009"},{"key":"R7","series-title":"Am J Trop Med Hyg","first-page":"502","article-title":"Asymptomatic infection with visceral leishmaniasis in a diseases-endemic area in Bihar, India","volume":"83","author":"Topno","year":"2010"},{"key":"R8","series-title":"Am J Trop Med Hyg","first-page":"334","article-title":"Asymptomatic human carriers of Leishmania chagasi","volume":"66","author":"Costa","year":"2002"},{"key":"R9","series-title":"Trop Med Int Health","first-page":"1792","article-title":"Visceral leishmaniasis in southeastern Nepal: a cross-sectional survey on Leishmania donovani infection and its risk factors","volume":"11","author":"Schenkel","year":"2006"},{"key":"R10","series-title":"J Clin Microbiol","first-page":"251","article-title":"Rapid, noninvasive diagnosis of visceral leishmaniasis in India: comparison of two immunochromatographic strip tests for detection of anti-K39 antibody","volume":"44","author":"Sundar","year":"2006"},{"key":"R11","series-title":"Transfusion","first-page":"1383","article-title":"Asymptomatic infection by Leishmania infantum in blood donors from the Balearic Islands (Spain)","volume":"48","author":"Riera","year":"2008"},{"key":"R12","series-title":"Am J Trop Med Hyg","first-page":"27","article-title":"Comparative study of serologic tests for the diagnosis of asymptomatic visceral leishmaniasis in an endemic area","volume":"81","author":"Romero","year":"2009"},{"key":"R13","series-title":"Am J Trop Med Hyg","first-page":"826","article-title":"Endemic kala-azar in eastern Sudan: a longitudinal study on the incidence of clinical and subclinical infection and post-kala-azar dermal leishmaniasis","volume":"51","author":"Zijlstra","year":"1994"},{"key":"R14","series-title":"Clin Exp Immunol","first-page":"349","article-title":"Dichotomy of protective cellular immune responses to human visceral leishmaniasis","volume":"140","author":"Khalil","year":"2005"},{"key":"R15","series-title":"Am J Trop Med Hyg","first-page":"275","article-title":"Kala-azar outbreak in Libo Kemkem, Ethiopia: epidemiologic and parasitologic assessment","volume":"77","author":"Alvar","year":"2007"},{"key":"R16","series-title":"Am J Trop Med Hyg","first-page":"566","article-title":"Evaluation of leishmanin skin test in Indian visceral leishmaniasis","volume":"80","author":"Gidwani","year":"2009"},{"key":"R17","series-title":"Trans R Soc Trop Med Hyg","first-page":"548","article-title":"Combined diagnostic methods identify a remarkable proportion of asymptomatic Leishmania (Leishmania) chagasi carriers who present modulated cytokine profiles","volume":"102","author":"De Gouv\u00eaa Viana","year":"2008"},{"key":"R18","series-title":"J Clin Microbiol","first-page":"131","article-title":"Asymptomatic Leishmania infantum infection in an area of northwestern Italy (Piedmont Region) where such infections are traditionally nonendemic","volume":"48","author":"Biglino","year":"2010"},{"key":"R19","series-title":"Am J Trop Med Hyg","first-page":"1051","article-title":"Human asymptomatic infection in visceral leishmaniasis: a seroprevalence study in an urban area of low endemicity. Preliminary results","volume":"77","author":"Barao","year":"2007"},{"key":"R20","series-title":"Clin Microbiol Rev","first-page":"334","article-title":"The relationship between leishmaniasis and AIDS: the second 10 years","volume":"21","author":"Alvar","year":"2008"},{"key":"R21","series-title":"Lancet","first-page":"371","article-title":"East African countries struggle with visceral leishmaniasis","volume":"374","author":"Burki","year":"2009"},{"key":"R22","series-title":"Clin Microbiol Rev","first-page":"298","article-title":"Leishmania and human immunodeficiency virus coinfection: the first 10 years","volume":"10","author":"Alvar","year":"1997"},{"key":"R23","series-title":"Ann Trop Med Parasitol","first-page":"877","article-title":"Environmental determinants of the distribution of Phlebotomus orientalis in Sudan","volume":"92","author":"Elnaiem","year":"1998"},{"key":"R24","series-title":"Ann Trop Med Parasitol","first-page":"367","article-title":"Preliminary entomological observations in a highland area of Amhara region, northern Ethiopia, with epidemic visceral leishmaniasis","volume":"101","author":"Gebre-Michael","year":"2007"},{"key":"R25","series-title":"Microbes Infect","first-page":"1439","article-title":"Epidemiologyof visceral leishmaniasis in Atbara River area, eastern Sudan: the outbreak of Barbar el Fugara village (1996\u20131997)","volume":"4","author":"El-Safi","year":"2002"},{"key":"R26","series-title":"Ann Trop Med Parasitol","first-page":"659","article-title":"Visceral leishmaniasis in Aba Roba, south-western Ethiopia: prevalence and incidence of active and subclinical infections","volume":"103","author":"Hailu","year":"2009"},{"key":"R27","series-title":"Clin Exp Immunol","first-page":"303","article-title":"Immune response measured in human volunteers vaccinated with autoclaved Leishmania major vaccine mixed with low dose of BCG","volume":"134","author":"Mahmoodi","year":"2003"},{"key":"R28","series-title":"Ann Trop Med Parasitol","first-page":"119","article-title":"A community-based, comparative evaluation of direct agglutination and rK39 strip tests in the early detection of subclinical Leishmania donovani infection","volume":"102","author":"Sinha","year":"2008"},{"key":"R29","series-title":"Am J Trop Med Hyg","first-page":"345","article-title":"Longitudinal seroepidemiologic study of visceral leishmaniasis in hyperendemic regions of Bihar, India","volume":"80","author":"Gidwani","year":"2009"},{"key":"R30","series-title":"Trans R Soc Trop Med Hyg","first-page":"550","article-title":"Immunity in kala-azar","volume":"55","author":"Manson-Bahr","year":"1961"},{"key":"R31","series-title":"J Infect Dis","first-page":"1124","article-title":"Epidemiology of visceral leishmaniasis in northeast Brazil","volume":"166","author":"Evans","year":"1992"},{"key":"R32","series-title":"Trans R Soc Trop Med Hyg","first-page":"102","article-title":"Detection of Leishmania infantum cryptic infection in asymptomatic blood donors living in an endemic area (Eivissa, Balearic Islands, Spain) by different diagnostic methods","volume":"98","author":"Riera","year":"2004"},{"key":"R33","series-title":"Am J Trop Med Hyg","first-page":"76","article-title":"Evaluation of a new recombinant K39 rapid diagnostic test for Sudanese visceral leishmaniasis","volume":"74","author":"Ritmeijer","year":"2006"},{"key":"R34","series-title":"BMJ","first-page":"723","article-title":"A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis","volume":"333","author":"Chappuis","year":"2006"},{"key":"R35","series-title":"Am J Trop Med Hyg","first-page":"102","article-title":"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","volume":"84","author":"Ca\u00f1avate","year":"2011"},{"key":"R36","series-title":"Am J Trop Med Hyg","first-page":"72","article-title":"A comparative study of the effectiveness of diagnostic tests for visceral leishmaniasis","volume":"70","author":"Boelaert","year":"2004"},{"key":"R37","series-title":"Am J Trop Med Hyg","first-page":"929","article-title":"Field evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopia","volume":"80","author":"Ter Horst","year":"2009"},{"key":"R38","series-title":"Clin Diagn Lab Immunol","first-page":"717","article-title":"rK39 enzyme-linked immunosorbent assay for diagnosis of Leishmania donovani infection","volume":"5","author":"Zijlstra","year":"1998"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/5\/article-p792.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/5\/article-p792.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/5\/article-p792.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T17:56:01Z","timestamp":1723053361000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/5\/article-p792.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,1]]},"references-count":38,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2012.11-0196","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,1]]}}}