The most effective diagnostic tests for leishmaniasis are invasive and potentially dangerous, where tissue samples are required from the spleen, lymph nodes, or bone marrow. These tests require lab facilities and specialists not readily available in resource-poor, endemic areas.
The most common method of diagnosing kala azar is by dipstick testing. However, this method is highly problematic. In endemic areas, people can become infected with kala azar but it may not develop into the disease. Therefore, no treatment will be required.
Unfortunately, dipstick testing only establishes whether a patient is immune to kala azar—so if the parasite is present it would appear that the patient has the disease. Because of this, dipstick testing can’t be used to see if the patient is cured, is re-infected, or has relapsed.