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Table 1 Advantages and limitations of immunological methods used in leishmaniases diagnosis

From: Leishmaniases diagnosis: an update on the use of immunological and molecular tools

Method

Antigen

Advantage

Limitation

Montenegro skin test

Killed whole parasites

Low cost and detection of T cell immunity

May not detect cases of visceral leishmaniasis in some stages of the disease. Cannot differentiate between infection and disease, nor active and progressive disease. Risk of recurrence.

Enzyme-Linked Immunoabsorbent Assay (ELISA)

Recombinant molecules

Low cost and high sensitivity and specificity

Sensitivity and specificity is highly dependent on the antigen used

Immunofluorescence

Killed whole parasites

High sensitivity and specificity

Laborious process, time and cost consuming. Need of trained personnel to perform the test.

Flow cytometry

Recombinant molecules and/or killed whole parasites have been tested

Better sensitivity and specificity when compared with all other methods. Small amount of blood. Can differentiate between infection and disease, and cured patients.

Cost associated with reagents and equipment. Few studies yet.

Rapid Antibody Test (RAT)

Recombinant molecules

Low cost, small amount of blood, fast

Sensitivity and specificity is highly dependent on the antigen used

Direct Agglutination Test (DAT)

Killed whole parasites

Low cost, small amount of blood

Need of long incubation time, well-trained laboratory technicians, antigen cost, and quality controlled antigen