02651nas a2200361   4500000000100000008004100001260001700042653002600059653002700085653002400112653002500136653003800161653003200199653001100231653001100242653002100253653001200274653000900286653002500295653003000320653003200350100001700382700002400399700001500423700001200438700001100450245011700461300001000578490000700588050003200595520164800627022001402275       1992                            d  c1992 Jan-Mar10aAntibodies, Bacterial10aAntibodies, Monoclonal10aAntigens, Bacterial10aBinding, Competitive10aEnzyme-Linked Immunosorbent Assay10aEvaluation Studies as Topic10aFemale10aHumans10aImmunoglobulin M10aleprosy10aMale10aMycobacterium leprae10aPredictive Value of Tests10aSensitivity and Specificity1 aKanchana M V1 aLakshminarayana C S1 aSengupta U1 aSinha S1 aRamu G00aAn appraisal of enzyme linked immunosorbent assay (ELISA) and serum antibody competition test (SACT) in leprosy.  a42-500 v64  aInfolep Library - available3 a<p>Seventy-eight untreated leprosy patients, 104 treated patients and 105 healthy contacts were tested using two serological tests, SACT (serum antibody competition test based on competitive inhibition of monoclonal antibody binding to the MY2a determinant of M. leprae) and ELISA (measurement of IgM antibodies to the neoglycoproteins D-BSA and ND-BSA representing the phenolic-glycolipid antigen of M. leprae). The controls included normal healthy individuals, patients with sputum positive pulmonary tuberculosis, and active cases of rheumatoid arthritis from the department of rheumatology. The specificity of SACT was found to be very high. ELISA was found to be positive in two patients with rheumatoid arthritis, one each for D-BSA and ND-BSA ELISA. Both tests had a high sensitivity in BL and lepromatous patients. The sensitivity to both tests was considerably lower in tuberculoid and BT patients i.e., below 40%. Therefore the diagnostic value of a negative test in suspected cases of leprosy was very low employing either of the two tests. A proportion of patients with paucibacillary tuberculoid and BT leprosy were positive after six months or longer after therapy. Similarly a large number of BL and lepromatous patients were positive after considerably longer periods of treatment. The use of either tests for determining the duration of therapy is therefore limited. SACT appears to be more sensitive than ELISA with ND-BSA in detecting subclinical infection. The cumulative positivity of the two tests may be used as a measure of the infectivity of the disease in the community and for evaluating disease control methods.</p>  a0254-9395