Diagnóstico de leptospirosis humana: Evaluación de la aglutinación macroscópica en diferentes etapas de la enfermedad

Abstract

Objective: To evaluate the macroscopic agglutination test using Temperature Resistant (TR) antigen as a screening test for the diagnosis of human leptospirosis in different stages of the disease. Materials and methods: The criteria for case definition were based on the results of the microscopic agglutination test (MAT), leukocyte counts and neutrophilia, resulting 218 confirmed cases and 242 non-cases. Each sample was classified according to the days of the disease progression in three stages: first (<10 days), second (10-25 days) and third (>25 days). The design was cross-sectional observational. Results: TR sensitivity was 71,1 % on stage I. 93.4% on stage 2 and 95.6% on stage 3. The specificity at different stages ranged from 79.0 to 69.2%. Intra and inter-operator variability was moderate. Conclusion: TR variability, low sensitivity in the first stage and low specificity found in all stages of the disease, suggest that it is essential to incorporate new diagnostic methods to screen for early detection of cases in our country and in countries that still apply such methods.