Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
Leprosy, caused by Mycobacterium leprae, presents with hypopigmented patches and hardening of nerves. Early diagnosis is crucial, especially in children. Current diagnostic methods include histopathological examination, polymerase chain reaction (PCR) and immunostaining, but these are limited and expensive. This study aims to compare the diagnostic value of skin slit smear for acid-fast bacilli (AFB) and Enzyme linked immunosorbent assay (ELISA) based detection of antibodies against Antigen 85C (Ag85C) for diagnosis of leprosy in paediatric population. The present prospective study included 30 children, below 16 years age with leprosy lesions and no prior history of anti-lepromatous treatment. After institutional ethical approval, the relevant clinical history and demographic details were recorded. Skin smears were collected and examined for AFB. ELISA was used to detect Ag85C antibodies in the serum of all patients. The 30 pediatric leprosy cases, included were of predominantly Borderline tuberculoid (BT) type. Male-to-female ratio was 1.5:1. Most cases had skin lesions and nerve trunk thickening. Ulnar nerve thickening was common in nerve involvement cases. AFB detection by skin slit smears was only 26.66% (08/30 cases), while ELISA based detection of Ag85C antibodies was positive in 83.33% (25/30 cases). ELISA for Ag85C antibodies showed 100% specificity in diagnosing leprosy. Moreover skin slit smear was universally negative in all cases of tuberculoid (TT) and borderline tuberculoid (BT), whereas ELISA was positive in 40% cases of TT and 86.6% cases of BT as well. Thus, ELISA had higher detection rate than AFB smear, especially in TT and BT type of leprosy. Overall, ELISA outperformed AFB smear in diagnosing leprosy cases (p<0.0009). The diagnostic potential of ELISA based antibody test, targeted against Ag85C in serum samples is a sensitive tool for diagnosis of early leprosy cases with negative AFB slit skin smears and no feasible skin biopsy. Larger studies are needed for further validation of results of present study.
How to cite this article:
Digvijay Chaudhary, Nandita Chaudhary and Sumit Sachan. A Comparative Evaluation of ELISA Employing Antigen 85C with Skin Slit Smear in Diagnosis of Leprosy in Children.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.9.120.124
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.9.120.124