Abstract
Leishmaniasis is endemic in the tropical and subtropical regions. 12 million cases occur worldwide with 1 to 1.5 million cutaneous and 500,000 visceral leishmaniasis (kala-azar, VL) occuring fresh every year. Leishmania-HIV coinfection is emerging in southern Europe where 25 to 70% of adults with VL have AIDS as well. In the Indian subcontinent, the disease is almost exclusively caused by L donovani. Diagnosis of kala azar (VL) is by demonstration of amastigotes in splenic or bone marrow smears or by culture of leishmania promastigotes from clinical specimen. While the sensitivity of splenic smears could be as high as > 95%, it carries the risk of severe/fatal haemorrhage. Bone marrow aspiration is painful, cumbersome and has a low sensitivity (60-85%). Culture can not be used for routine clinical diagnosis as it requires expensive equipment and expertise [1].
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