Evaluation of DAT in the Diagnosis of Visceral Leishmaniasis in Children Hospitals in Tabriz from 1992 to 1996

Since the bone marrow puncture and its study is a time-consuming and costly process and in addition, the direct agglutination test has a high sensitivity and is easier and quicker to perform for the diagnosis of Kala-azar, and considering the less value of bone marrow puncture for the definite diagnosis of endemic hepatosplenomegaly in Meshkinshahr, this study was performed to determine the diagnostic value of DAT in Kala-azar-afflicted patients in children hospitals in Tabriz during the years 1992-1996. The present study was carried out on the existing data of 109 patients hospitalized the Tabriz children hospitals from 1992 to 1996. Out of them, 9 cases were excluded from the study because of imperfect records and lack of follow-up. Only the patients were selected that the result of their agglutination test was 1/3200 or greater, leishmania was observed in their tissue samples and/or responded positively to glucantim and were evaluated on the basis of age, gender, living place, clinical symptoms and laboratory results, diagnosis and treatment. Out of 100 cases, 65 were male (65%) and 35 were female (35%) and 95% of them were under the age of 4 years and 83% of the patients were from Ardebil and Ahar. The most common clinical symptoms were splenomegaly (100%), fever (97%), and anemia (90%). The laboratory findings were a high ESR, pancytopenia, and the presence of leishmania in the bone marrow. The result of direct agglutination test was positive in 96% of the cases. The diagnosis of visceral leishmaniasis is rather difficult through observing leishmania in the reticuloendothelial system and requires much experience. The antigenic tests such as Elisa and immunofluorescence are expensive and are not possible in all health centers. The direct agglutination test of the serum is less expensive and more applicable and has a greater sensitivity.