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Am. J. Trop. Med. Hyg., 65(3), 2001, pp. 193-196
Copyright © 2001 by The American Society of Tropical Medicine and Hygiene

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American Journal of Tropical Medicine and Hygiene, Vol 65, Issue 3, 193-196
Copyright © 2001 by American Society of Tropical Medicine and Hygiene

Research Articles


Resistance to treatment in Kala-azar: speciation of isolates from northeast India

S Sundar, K Pai, R Kumar, K Pathak-Tripathi, AA Gam, M Ray, and RT Kenney

Kala-azar in India is becoming increasingly difficult to treat, which may be due to the presence of species other than Leishmania donovani; Leishmania tropica was reported to cause the same clinical syndrome in the area. Over the past 3 years, we have collected samples from 241 patients with visceral leishmaniasis from across the region. Of the 189 isolates that grew on diphasic medium, 159 were successfully transferred to liquid medium for typing. Clinically, 80% of these were resistant to antimony. Lipophosphoglycan-specific monoclonal antibodies were used to distinguish the 2 species by agglutination of promastigotes; all 159 were shown to be L. donovani. Eighty-three isolates were confirmed to be L. donovani by isoenzyme analysis, by amplification of kinetoplast DNA, or both, in comparison with multiple reference strains; none were L. tropica. Thus, the rising incidence of clinical resistance to treatment is unlikely to be due to a different species causing kala-azar in north Bihar.


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