LEISHMANIN AND TUBERCULIN SENSITIVITY IN LEISHMANIASIS IN THE SUDAN, WITH SPECIAL REFERENCE TO KALA-AZAR

The application of leishmanin and tuberculin skin tests was studied in patients with leishmaniasis in the Sudan. 35 cases of active kala-aza r and 3 relapse cases were leishmanin negative. 81% of patients treate d for kala-azar showed a positive reaction after 6 months. 17 of 29 pa tients with post kala-azar dermal leishmaniasis (PKDL) were leishmanin positive. 2 of 16 patients with kala-azar tested with tuberculin were positive; one was diagnosed as tuberculosis. In 7 initially tuberculi n negative patients, the tuberculin test became positive after treatme nt. A new Leishmania major skin test antigen (Pasteur Institute, Iran) was more reactive than other antigens in patients with cutaneous leis hmaniasis, mucocutaneous leishmaniasis and PKDL, but not in treated ka la-azar cases. In a field study in an area of endemic kala-azar, the n ew L. major antigen proved more reactive both in individuals previousl y exposed to L. major (causing cutaneous leishmaniasis) and in those w ith past exposure to L. donovani. The literature concerning skin testi ng with leishmanin and tuberculin in kala-azar is reviewed.