Table 2.
Analysis of 5 diagnostic tests used in the evaluation of secondarily infected and uninfected ulcers, as well as purely ulcerative and nonulcerative lesions suspected to be cutaneous leishmaniasisd
| Assay | Result [% (95% CI)] for: |
|||||||
|---|---|---|---|---|---|---|---|---|
| Secondarily infected ulcers (n = 8) |
Uninfected ulcers (n = 62) |
Purely ulcerative lesions (n = 70) |
Verrucous or nodular lesions (n = 15) |
|||||
| Sensitivity | Specificity | Sensitivity | Specificity | Sensitivity | Specificity | Sensitivity | Specificity | |
| LSTa | 20.0 (0–49.6) | 100.0 | 72.2 (59.7–84.7) | 71.4 (46.8–96) | 65.9 (53.5–78.3) | 75.0 (52.3–97.7) | 40.0 (11–69) | 100.0 |
| Smear | 57.1 (20.4–93.8) | 100.0 | 49.0 (35–63) | 100.0 | 50.0 (36.9–63.1) | 100.0 | 45.5 (16.1–74.9) | 100.0 |
| kDNA PCR of invasive specimensb | 100.0 | 100.0 | 89.8 (81.3–98.3) | 84.6 (65–100) | 91.1 (83.6–98.6) | 85.7 (67.4–100) | 100.0 | 100.0 |
| kDNA PCR of lesion aspirates | 100.0 | 100.0 | 75.5 (63.5–87.5) | 92.3 (77.8–100) | 78.6 (67.9–89.3) | 92.9 (79.4–100) | 90.9 (73.9–100) | 100.0 |
| kDNA PCR of lesion scrapings | 85.7 (59.8–100) | 100.0 | 79.6 (68.3–90.9) | 92.3 (77.8–100) | 80.4 (70–90.8) | 92.9 (79.4–100) | 72.7 (46.4–99) | 100.0 |
| kDNA PCR of noninvasive specimensc | 100.0 | 100.0 | 87.8 (78.6–97) | 92.3 (77.8–100) | 89.3 (81.2–97.4) | 92.9 (79.4–100) | 72.7 (46.4–99) | 75.0 (32.6–100) |
| Culture | 28.6 (0–62.1) | 100.0 | 34.7 (21.4–48) | 100.0 | 33.9 (21.5–46.3) | 100.0 | 37.5 (8.9–66.1) | 100.0 |
a
LST, leishmanin skin test. Two individuals did not undergo leishmanin skin testing.
b
Includes pooled analysis of lesion aspirates and scrapings.
c
Includes filter paper lesion impressions.
d
CI, confidence interval.