Leprosy Mailing List – March 3, 2013
Ref.: (LML) New Diagnostic Test
From: Dominique Frommel, Geneva, Switserland
Dear Dr. Schreuder,
I would like to refer to the LML letter "New Diagnostic Test" of February 26 and to the response by Dr. Barreto of February 28, 2013.
The present available serological assays for the diagnosis of leprosy correlate with the bacillary load. They are largely positive for multibacillary leprosy (MB), their titre decrease during MDT and, in a few instances, predict the development of the disease.
The test elaborated by the Infectious Disease Research Institute (IDRI), Seattle, in conjunction with OrangeLife, a Brazilian diagnostic company, is based on two antigens, NDO, a synthetic-mimetic phenolic glycolipid 1 and LID-1, a fusion construct of two recombinant M.leprae proteins. The test is simple, similar to the home pregnancy test, and can be used at the point-of-care.
The specificity of the "Rapid diagnostic for leprosy" has been carefully evaluated and nearly all sera from active MB patients are positive. However, as for assays relying on PGL-1, its aptitude to diagnose paucibacillary leprosy (PB) is inconsistent.
While the "Rapid diagnostic for leprosy" will be a useful auxiliary tool for the assessment of treatment efficacy and disease relapse, it is not the universal test adapted to diagnose every facet of M. leprae infection. Achievement of leprosy control requires dependable technical tools but its first needs are skilled health professionals.
Regards,
Dominique Frommel
Formerly A. Hansen Research Institute, Addis Ababa.
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML Archives: http://www.aifo.it/english/resources/online/lml-archives/index.htm
Contact: Dr Pieter Schreuder << editorlml@gmail.com >>.
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