Diagnosis of kala-azar

Direct method – This is conclusive test for the demonstration of L.D bodies . The finding of the parasite may be obtained by following ways –

 A.. By the examination of smears from –

(a)    Peruipheral Blood –

    

i)                    By making a thick blood film

ii)                  B producing a straight leucocytic edge .

iii)                By centrifuging a citrated blood .

(b)    Spleen or liver puncture

(c)    Sternal puncture .

B.. Culture – The organism may be cultured in citrated blood in a moist tube of N.N.N medium ( novy Mac Neal Nicolle medium ).

    

Indirect method –

A.. blood coungt

  

a)      Haemoglobin percentage – about 40%

b)      Total count of R.B.C – Decreased .

c)      Total count of W.B.C – Leucopenia ( about 3000/cmm)

d)     Total count of platelet – Normal or below .

e)      Differential count –

a)      Neutropenia

b)      Absence of Eosinophil

c)      Lymphocytosis

d)     Monocytosis .

B..  Serological test

1.      Test based on increase of globulin of blood –

(a ) Aldehyde test -  This test depend on an  increase of serum gamma globulin . The test will not be positive in case of less than three months duration of the disease and in this period , the spleen will enlarged .

(b) Chopra’s antimony test – The test depend upon an increase of serum gamma globulin .

2.. Test based on the presence of antibody in the serum

( a ) Compliment fixation test with W.K.K antigen – The test is a distinct advantage for early diagnosis of kala-azar .

     (b) agglutination test – Usually this test is not done .