ABSTRACT
Leishmania donovani are generally not known to harbour animal reservoirs. Timely case detection and treatment of patients are, therefore, important in disease control. However, poor self-referral, under diagnosis, and underreporting of leishmaniasis are major concerns in affected countries. Due to lack of characteristic clinical markers, laboratory diagnosis is preferred for disease confirmation. Few attempts on active case detection surveys, description of the clinical profile, and development of a clinical scoring system and method comparison studies have been reported. A two-staged clinical scoring system with markers for field-friendly screening and markers for clinical management decision for cutaneous leishmaniasis has been introduced. Routine diagnosis is carried out by light microscopy on infected tissues in suspected patients. Parasite cultures and PCR assays using various protocols are performed at limited number of research centres for microscopy-negative patients. Loop-mediated isothermal amplification assay has been tested. Authors reported relatively low sensitivity and negative predictive value when compared to microscopy and PCR. Standard serological assays have a limited value in the local setting.
