Epidemiological survey of leishmaniasis using skin test and ELISA in Ecuador.

The present study was designed to evaluate the intradermal skin test (ST) and the ELISA as diagnostic tools in the screening for Ecuadorian cutaneous and mucocutaneous leishmaniasis. The antigen for skin testing was prepared from ruptured promastigotes of Leishmania braziliensis. The ST and ELISA positive rates among 72 subjects with active dermal lesions were 81.8% (36/44) and 81.3% (52/64), respectively, while parasites were observed in 31 (44.9%) of 69 subjects presenting active lesions. In the parasites positive cases, all subjects proved to be positive for the two tests except for one in ST and two in ELISA. In 35 healed cases, the ST and ELISA positive rates were 86.2% (25/29) and 72.4% (21/29), respectively. On the other hand, the positive rate in subjects without clinical signs was only 3.8% in ST and 8.2% in ELISA. An epidemiological survey in Selva Alegre, Esmeraldas, revealed that among 115 inhabitants 38 were positive for the clinical signs, 10 active and 28 healed cases. Of these subjects 33 (86.8%) showed positive reactions against ST and/or ELISA. Based on the results obtained, therefore, we concluded that the present skin testing antigen and ELISA were very useful for the screening of leishmaniasis in the endemic areas of Ecuador.