LEISHMANIA-DONOVANI PARASITES IN THE NASAL SECRETIONS, TONSILLOPHARYNGEAL MUCOSA, AND URINE CENTRIFUGATES OF VISCERAL LEISHMANIASIS PATIENTS IN KENYA

In the early 1930s, investigators of visceral leishmaniasis stated tha t Leishman-Donovan bodies are found in body fluids of kala-azar patien ts, for example, in urine, feces, semen, and nasal and pharyngeal secr etions. Based on this finding, we investigated the diagnostic potentia l of nasal secretions, tonsillopharyngeal mucosal swabs, and urine cen trifugates inoculated into Schneider's Drosophila Medium (containing a ntibiotics and antifungal agents) as well as with Giemsa-stained smear s. Consequently, 64 randomly selected patients with visceral leishmani asis from Kenya (59 who were splenic culture or Giemsa stain positive and five who were culture negative but Giemsa stain positive) were tes ted by three noninvasive methods. These tests were all performed befor e the patients were treated with Pentostam.(R) Cultures of nasal and t onsillopharyngeal swabs and urine centrifugates produced 28 positive s amples representing 24 patients (37.5%). Moreover, a set of 25 Giemsa- stained slide smears made from the nasal and tonsillopharyngeal mucosa of 25 patients with visceral leishmaniasis who had not tested positiv e in cultures produced nine positives. Therefore, the overall total of patients who tested positive by all of the above methods was 33 or 51 .6%. The cryopreserved Leishmania isolates were characterized by cellu lose acetate electrophoresis using 20 enzyme systems. The isoenzyme pr ofiles produced by the parasites were represented in five different L. donovani s.l. zymodemes. Representatives of these isolates were also characterized by DNA Southern blotting analysis, which corroborated th e isoenzyme results.