Comparison of rk-39 Dipstick Rapid Test with Splenic Aspiration for the Diagnosis of Kala- Azar in Children - A Hospital Based Study

摘要

Objective : To compare rK 39 dipstick test with splenic aspiration the gold Standard for diagnosis of kala azar, and to find out sensitivity of rk-39 dipstick rapid test, in our setting and /.' evaluate its utility as rapid, non invasive, and reliable field diagnostic test in children. Design : Prospective, clinical, hospital based. Setting : The present study "Comparison of an rk-39 Dipstick rapid test with splenic aspiration for. the diagnosis of kala-azar in children - A hospital based study" was carried out over a period of one and half year, amongst randomly selected 50 patients of kala-azar admitted in indoor ward of Department of Pediatrics, Darbhanga Medical College and Hospital, Darbhanga. Method Diagnosis of kala-azar was made after taking history, a thorough clinical examina-tion invasive and non-invasive investigations. Demonstration of parasite (amastigote) on stained giemsa/leishman smear of splenic aspirates was done. Finally rk-39 strip test was done to examine its concordance (sensitivity) with splenic smear examination which is still the gold standard for the diagnosis of kala-azar. Result : It was found that rk-39. were positive in 96% ot cases while splenic aspiration were positive in 90% of cases, splenic aspiration negative and rk-39 test positive an cases were confirmed as kala-azar by bone marrow aspiration, then treated as a kala azar.AII patients responded to treatment.rk39 dipstick showed a positive correlation with splenic aspiration, which has a high statistical significance, rk-39 dipstick rapid test became positive in early course of illness, whereas it is difficult to detect LD bodies in the beginning of illness. Al-though patients with very low platelet and prolonged PT were excluded, 8 out of 50 suffered from local hematoma.