Wellness & Fitness

New test to improve kala-zar diagnosis

test

A medic talks to a mother with a child suffering from Kala-zar at a public heath facility. FILE PHOTO | NMG

Kenya could soon benefit from a new test that seeks to improve he diagnosis of a fatal and infectious disease known as visceral leishmaniasis or kala-azar, which is characterised by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, as well as anaemia.

The test, known as Loop Mediated Isothermal Amplification (LAMP) uses DNA technology to identify parasites that cause the disease in human blood.

It is considered safe and easy to use compared to microscopes that are currently used to diagnose the disease.

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Even though LAMP has been shown to work well in other countries, the Kenya Medical Research Institute (Kemri) and the Foundation for Innovative New Diagnostics (FIND) are currently evaluating its performance in the Kenyan context.

“We want to see if it will work well in Kenya as it has done in other countries. We actually want to know how effective it will be in picking up kala-azar cases here,” Dr Margaret Mbuchi, principal investigator of the evaluation study and senior researcher at Kemri told the Business Daily.

The current Gold Standard test for diagnosing kala-azar involves the use of a special microscope that clinicians use to visually check for the presence of parasites that cause the disease in body tissues.

Despite its ability to yield accurate results, this diagnostic approach uses tissue samples (biopsies) which have to be collected from the spleen or bone marrow through an invasive procedure that is often painful, risky and uncomfortable for patients.

“A fine needle is inserted through the abdomen into the spleen to get the tissue samples. In the process, someone can accidentally hit a blood vessel and cause internal bleeding that can lead to death,” said Dr Joseph Ndung’u, head of neglected tropical diseases (NTD) at FIND.

Bone marrow samples on the other hand, are retrieved through hollow needles that are inserted into the sternum or breast bone. It may cause excessive bleeding or long lasting discomfort in certain instances.

According to Dr Ndung’u, the new LAMP technology will eliminate these challenges since it can effectively diagnose the disease using blood samples drawn from finger pricks or veins in the hand, as is common with blood tests for other ailments.

“The new technology will also save patients from hospitalisation which is usually required before samples can be collected from the spleen or bone marrow for use in microscopy tests.

Afterwards, patients are still retained for observation to ensure that they don’t suffer from any adverse side effects,” said Dr Mbuchi.

The LAMP will also be beneficial to patients suffering from bleeding disorders who cannot be subjected to microscopy tests since they may bleed to death as doctors collect tissue samples from the sensitive organs.

Due to the complex and delicate nature of the test, microscopy diagnosis for kala-azar is confined to just a few healthcare facilities with the expertise to conduct it in Kenya.

But since LAMP is safe and easy to use, Dr Ndung’u noted that it can effectively be rolled out in many facilities found in high risk areas.

“You collect the samples easily, and then you mix the blood with a reagent and simply wait for the digital LAMP device to display the results since the process is automated.”

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