Scoring clinical signs can help diagnose canine visceral leishmaniasis in a highly endemic area in Brazil
Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological te...
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Veröffentlicht in: | Memórias do Instituto Oswaldo Cruz 2018-06, Vol.112 (1) |
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Zusammenfassung: | Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in
endemic areas with limited diagnostic resources. This study proposes a
score with the potential to distinguish positive CVL cases from
negative ones. We studied 265 dogs that tested positive for CVL on
ELISA and parasitological tests. A score ranging between 0 and 19 was
recorded on the basis of clinical signs. Dogs with CVL had an overall
higher positivity of the majority of clinical signs than did dogs
without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph
nodes (83.93%), muzzle/ ear lesions (55.36%), nutritional status
(51.79%), bristle condition (57.14%), pale mucosal colour (48.21%),
onychogryphosis (58.93%), skin lesion (39.28%), bleeding (12.50%),
muzzle depigmentation (41.07%), alopecia (39.29%), blepharitis
(21.43%), and keratoconjunctivitis (42.86%) were more frequent in dogs
with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the
clinical score increased according to the positivity of all diagnostic
tests (ELISA, p < 0.001; parasite culture, p = 0.0021; and smear, p
= 0.0003). Onychogryphosis (long nails) [odds ratio (OR): 3.529; 95%
confidence interval (CI): 1.832-6.796; p < 0.001], muzzle
depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p < 0.001), and
keratoconjunctivitis (OR: 5.400; 95% CI: 2.549-11.441; p < 0.001)
were highly associated with CVL. Interestingly, a score cut-off value
≥ 6 had an area under the curve of 0.717 (p < 0.0001),
sensitivity of 60.71%, and specificity of 73.64% for CVL diagnosis. The
clinical sign-based score for CVL diagnosis suggested herein can help
veterinarians reliably identify dogs with CVL in endemic areas with
limited diagnostic resources. |
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ISSN: | 1678-8060 |