Diagnosis of splenomegaly caused by malaria and Kala – Azar

Abstract

Splenic sizes, parasitaemia, total white blood cell count (WBC-T), differential white blood cell count (WBC-D), direct agglutination test (DAT), RK39 dip stick test and enzyme linked immunosorbent assay (ELISA) were used to diagnose malaria, tropical splenomegaly syndrome (T.S.S), kala-azar (KA) and other causes of splenomegaly on 93 clinically confirmed splenomegaly patients. There were 42 malaria patients, 28 T.S.S patients, 18 kala-azar patients and 5 cases of other causes of splenomegaly. Malaria patients recorded small spleens < 6cm) whereas kala-azar cases produced large spleens (> 10cm). The study on splenic sizes showed that there was significant differences between diseases (ANOYA, F3, 5(1) = 18.86, P < 0.01). Comparisons involving WBC-T, revealed that there was no significant difference amongst diseases (ANOVA, F3, 5(1) = 0.44, P > 0.726). The DAT had a sensitivity of 100% and specificity of 94.67%. The RK39 had a sensitivity of 83.3% and specificity of 97.3%. ELISA for malaria had a sensitivity of 90% and specificity of 69.56%, that of kala-azar had a' sensitivity of 100% and specificity of 90.7%. The results obtained from this study have shown that it is possible to diagnose malaria, T.S.S and kala-azar as follows: small tender spleens < 6 cm) with WBC-T of > 4,000 cells / mm : malaria, big tender spleens (> 10 em) with WBC-T pf > 4,000 cells / mrn-: T.s.s, big tender spleens ( > 10 cm) . with WBC-T of > 4,000 cells / mm3: without eosinophils will diagnose kala-azar. This is a. cheap user-friendly and rapid method of differential diagnosis.