dc.contributor.author |
Grogl, Max |
|
dc.contributor.author |
Joya, Christie A. |
|
dc.contributor.author |
Saenz, Maria |
|
dc.contributor.author |
Quispe, Ana |
|
dc.contributor.author |
Rosales, Luis Angel |
|
dc.contributor.author |
del Pilar Santos, Rocio |
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dc.contributor.author |
De los Santos, Maxy B. |
|
dc.contributor.author |
Donovan, Ngami |
|
dc.contributor.author |
Ransom, Janet H. |
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dc.contributor.author |
Ramos Ttito, Ana Pilar |
|
dc.contributor.author |
Llanos Cuentas, Elmer Alejandro |
|
dc.coverage.spatial |
Universidad Peruana Cayetano Heredia, Lima, Perú |
|
dc.coverage.spatial |
Jorge Chávez, Tambopata, Madre de Dios, Perú |
|
dc.coverage.spatial |
Iberia, Madre de Dios, Perú |
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dc.coverage.spatial |
Santa Rosa, Madre de Dios, Perú |
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dc.date.accessioned |
2023-04-16T04:38:13Z |
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dc.date.available |
2023-04-16T04:38:13Z |
|
dc.date.issued |
2023 |
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dc.identifier.uri |
https://hdl.handle.net/20.500.12866/13371 |
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dc.description.abstract |
Background Cutaneous leishmaniasis (CL) is a neglected disease and a public health problem in Latin America. The diagnosis of CL in poor hyperendemic regions relies to large extent on the identification of amastigotes in Giemsa-stained smears. There is an urgent need for a rapid, sensitive and low cost diagnostic method for use in field conditions for CL as current modali-ties are not readily available. The primary objective of this study was to determine the sensitivity and specificity of the FDA-cleared CL Detect Rapid Test in Peru, using modified test procedures rather than the instructions-for-use, by 1) increasing the extraction time and 2) increasing the volume of the sample added to the test strip. CL Detect Rapid Test results were compared against microscopy and kDNA-PCR, for the diagnosis of CL in ulcerated lesions. In addition, we compared two collection methods the dental broach used and men-tioned in the CL Detect insert and the standard less invasive and easier to conduct scrap-ping method. Methodology Participants were patients who presented for medical consultation due to a suspected CL lesion. Four samples from the index lesion were collected using a dental broach, per package insert, and lancet scraping and tested by the modified CL Detect Rapid Test, micros-copy, and PCR. Principal findings A total of 156 subjects were eligible and evaluated. The modified CL Detect sensitivity was higher in specimens obtained by scraping (83.3%) than those from dental broach (64.2%). The specificity was lower in scrapings (77.8%) with a false positive rate of 22.2% compared with dental broach samples (91.7%) with a false positive rate of 8.3%. However, molecular analysis showed that all 8 false negative microscopy scrapings (those positive by modified CL Detect and negative by microscopy) were positive by kDNA-PCR, meaning that the modified CL Detect was more sensitive than microscopy. Conclusions These modifications to the package insert that resulted in a diagnostic sensitivity (83.3%) comparable to microscopy for species found in Peru may enable earlier anti-leishmanial drug treatment decisions based on a positive result from the CL Detect Rapid Test alone until further diagnostic tests like microscopy and PCR can be performed. Trial registration NCT03762070; Clinicaltrials.gov. © 2023, Public Library of Science. All rights reserved. |
en_US |
dc.language.iso |
eng |
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dc.publisher |
Public Library of Science |
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dc.relation.ispartofseries |
PLoS Neglected Tropical Diseases |
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dc.rights |
info:eu-repo/semantics/restrictedAccess |
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dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
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dc.subject |
Specimen scraping |
en_US |
dc.subject |
Leishmania |
en_US |
dc.subject |
Amastigotes |
en_US |
dc.subject |
Lesions |
en_US |
dc.subject |
Leishmaniasis |
en_US |
dc.subject |
Diagnostic medicine |
en_US |
dc.subject |
Peru |
en_US |
dc.subject |
Polymerase chain reaction |
en_US |
dc.title |
Evaluation of a diagnostic device, CL Detect rapid test for the diagnosis of new world cutaneous leishmaniasis in Peru |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pntd.0011054 |
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dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.06 |
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dc.relation.issn |
1935-2735 |
|