Challenges in identification of Kala azar in India

Visceral Leishmaniasis (VL) is a vector borne anthrozoonotic disease caused by a protozoan, Leishmania donovani, of Trypanosomatidae family. The most precise methods used for its diagnosis includes the analysis of spleen & liver smears (90%), Bone Marrow smear (80%), sternal or iliac crest puncture but these all are not reliable and cumbersome/painful also. Various serological tests like indirect haemagglutination assay (IHA), countercurrent immuno-electrophoresis (CCIEP), Immunodiffusion (ID), Direct agglutination test (DAT), Indirect fluorescent antibody test (IFAT), ELISA etc. are also used to diagnose VL. In the case of immunocomprised patient, diagnosis of VL is difficult due to low titer of antibody. Recently PCR based diagnosis and a latex agglutination test (KATEX) has been developed for the detection. The current article is devoted to the detection of specific antigen whish are useful in diagnosis of VL in VL patients as well as in immunocomprised patients.