Serological tests fail to discriminate dogs with visceral leishmaniasis that transmit Leishmania infantum to the vector Lutzomyia longipalpis

Rev Soc Bras Med Trop. 2017 Jul-Aug;50(4):483-488. doi: 10.1590/0037-8682-0014-2017.

Abstract

Introduction: The control of reservoirs for Leishmania infantum -induced zoonotic visceral leishmaniasis requires the identification of dogs posing a population risk. Here, we assessed the performance of several assays to identify Lutzomyia longipalpis infectious dogs.

Methods: We evaluated 99 dogs that were positive for visceral leishmaniasis based on parasite identification. Serological analyses were performed using an enzyme-linked immunosorbent assay, immunofluorescence antibody tests in 1:40 and 1:80 dilutions, rapid dual path platform tests, immunochromatographic assay with a recombinant rK39 antigen, fast agglutination screening tests, and direct agglutination tests. We also performed PCR to analyze peripheral blood and xenodiagnosis.

Results: Forty-six dogs infected at least one L. longipalpis specimen. Although the serological test sensitivities were above 85% for detecting L. longipalpis infectious dogs, none showed a satisfactory performance, as both specificity (0.06 to 13%) and the area under the receiver operating characteristic curve (45 to 53%) were low. The PCR results were also weak, with a sensitivity of 30%, specificity of 72%, and an area under the receiver operating characteristic curve of 51%. The infected L. longipalpis proportion was higher among asymptomatic dogs than symptomatic dogs. Among the symptomatic dogs, those with ulceration-free skin diseases were more infectious, with an odds ratio of 9.3 (confidence interval of 1.10 - 428.5). The larger the number of insects fed, the greater the detected infectiousness.

Conclusions: Our study supports the imperative to develop novel technologies for identifying the infectious dogs that transmit L. infantum for the benefit of public health.

MeSH terms

  • Animals
  • Antibodies, Protozoan / blood*
  • Dog Diseases / diagnosis*
  • Dog Diseases / parasitology
  • Dog Diseases / transmission
  • Dogs
  • Female
  • Leishmania infantum*
  • Leishmaniasis, Visceral / diagnosis
  • Leishmaniasis, Visceral / parasitology
  • Leishmaniasis, Visceral / transmission
  • Leishmaniasis, Visceral / veterinary*
  • Male
  • Mosquito Vectors / parasitology*
  • Psychodidae / parasitology*
  • Sensitivity and Specificity
  • Serologic Tests / methods
  • Serologic Tests / veterinary*

Substances

  • Antibodies, Protozoan