VISCERAL LEISHMANIASIS IN SOMALIA - CIRCULATING ANTIBODIES AS MEASURED BY DAT, IMMUNOFLUORESCENCE AND ELISA

Sera from patients with visceral leishmaniasis (VL) (n=26), healthy re sidents of Mogadishu (n=157), inhabitants of a village in an endemic a rea (n=276) and healthy Swedes (n=60) were examined using the direct a gglutination test (DAT), immunofluorescence (IF) and ELISA for antibod ies against Leishmania donovani. The study was carried out in order to provide baseline data for antibody responses in visceral leishmaniasi s as existing in Somalia and to explore which one of these methods wou ld be most suitable for diagnosis of clinical cases as well as for epi demiological population studies in Somalia. All patients had high leve ls of circulating antibodies, however, lower values were recorded in t he early stages of the disease High reactivity in ELISA was seen first after one year. All three tests distinguished well between sera from VL patients and healthy controls. Approximately 10% of the sera from v illagers were reactive above the cut-off levels in the three tests. DA T is the simplest to perform and does not require much equipment. ELIS A can be made simple and economic if performed in one serum dilution a nd read visually. IF requires more expensive and specialized equipment and is not suitable for large scale examination of sera. A complete e valuation of the three tests should also include the analysis of sera from various stages and manifestations of the disease.