USE OF PCR ON LYMPH-NODE SAMPLES AS TEST OF CURE OF VISCERAL LEISHMANIASIS

When the polymerase chain reaction (PCR) was used to test lymph-node a spirates from 35 patients from eastern Sudan, who had had visceral lei shmaniasis but were believed cured, leishmanial DNA was detected in sa mples from 14 of the patients. There were no significant differences b etween the PCR-positives and -negatives in terms of age, sex, spleen s ize, malaria status or presence of anti-Leishmania antibodies. However , PCR was more often positive in the patients who tested negative by t he leishmanin skin test (LST) than in those who gave positive skin tes ts. Moreover, patients with a positive PCR and a negative LST converte d more often to LST positivity than those with a negative PCR and a ne gative LST. The most important finding was that, during follow-up, eig ht (57%) of the PCR-positives, but none of the 21 negatives, developed post-kala-azar dermal leishmaniasis (PKDL). In conclusion, PCR-based testing of lymph-node aspirates after treatment may be used as a progn ostic marker for the future development of PKDL and may be useful in t he follow-up of patients.