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Annex II. Assessment tool

National Leishmaniasis Training Pre- and Post- Training Assessment Tool

Code number: ____________________

  1. Which one of the following countries is among the high VL burden countries in the world?
    1. Nepal
    2. Somalia
    3. Brazil
    4. Vietnam


  1. Which one of the following is properly matched for the life cycle of leishmania?
    1. Amastigotes – bone marrow
    2. Amastigotes – sand fly salivary glands
    3. Promastigotes – human blood
    4. Promastigotes – taken by sandfly during blood meal


  1. Which one of the following is potential reservoir for VL in Ethiopia?
    1. Dogs
    2. Cattle
    3. Wild animals (fox)
    4. Humans


  1. Which of the following cytokines is found in high amount in a VL patient?
    1. TNFα
    2. TNFβ
    3. IL10
    4. IL12


  1. Which one of the following is less common clinical feature of VL in Ethiopia?
    1. Fever
    2. Splenomegaly
    3. Weight loss
    4. Lymphadenopathy


  1. Which of the following is less likely differential diagnosis for a patient with splenomegaly of 10cms below the costal margin?
    1. Visceral leishmaniasis
    2. Hyperreactive malarial splenomegaly syndrome
    3. Hepatosplenic schistosomiasis
    4. Typhoid fever


  1. A-32-year old man presented with swelling of his gum and palate. His teeth were loose and he also had submandibular lymphadenopathy. During biopsy, the tissue was very fragile and easily bleeding. Biopsy showed LD bodies stuffed in macrophages. No other pathology was detected on the biopsy examination. What should be the next examination for this patient?
    1. HIV testing
    2. Repeating the biopsy
    3. Prothrombin time
    4. Platelet count


  1. A 24 years old farmer from Metema are presented with high grade fever of 1 month duration associated with weight loss, intermittent vomiting and abdominal swelling to a health center. There was no other complication or additional disease detected. The health officer checked for rK39 ICT which was found to be positive. What should be the next step?
    1. Refer the patient for splenic aspiration
    2. Initiate treatment for VL
    3. Treatment should be initiated only if the tissue aspiration show LD bodies
    4. Perform DAT


  1. Which one of the following is correct regarding rK39 ICT?
    1. It has to be used only when the patient has the clinical case definition for VL.
    2. The positive predictive value of the test is almost 100%.
    3. rK39 ICT has to be used as screening test to do tissue aspiration.
    4. All patients with fever and from the VL endemic area should be screened with rK39.


  1. A 30 years old daily laborer presented with high grade fever, diarrhea, weight loss and cough. He was treated for VL before six months. On physical examination, he was emaciated; blood pressure was 80/40mmHg and had splenomegaly of 6cms below the costal margin. Lab investigations showed WBC count of 1800/µl; platelet of 34,000/µl; hemoglobin of 6gm/dl. How can VL be best diagnosed in this patient?
    1. rK39 RDT
    2. DAT
    3. Splenic aspiration
    4. Bone marrow aspiration


  1. Which one is the preferred treatment regimen for primary VL according to the Ethiopian national guidelines?
    1. AmBisome
    2. AmBisome plus Miltefosine
    3. Sodium stibogluconate
    4. Sodium stibogluconate plus paromomycin


  1. A VL patient on treatment complained of epigastric pain and had repeated vomiting of ingested material starting the seventh day of treatment. On investigation stool microscopy did not show parasites or ova. Serum creatinine was 1.8mg/dl, SGOT was 45u/L, SGPT was 54u/L, amylase was 942u/L and lipase was 500u/L. Which medicine can be the cause of these symptoms?
    1. Ambisome
    2. Miltefosine
    3. Sodium stibogluconate
    4. Paromomycin


  1. A 25 years old daily laborer presented with popular rash around his nose and mouth area. This happened after 6 months he was discharged cured of VL. What should be done at this stage?
    1. Initiate systemic antileishmania treatment
    2. Treat with topical antileishmania
    3. Skin biopsy
    4. Observation and follow up


  1. A 32 years old VL patient was admitted for treatment. On investigation serum creatinine was 2.8mg/dl, SGOT was 53u/L, SGPT was 44u/L, amylase was 190u/L. Which medicine is the drug of choice to treat this patient?
    1. Ambisome
    2. Miltefosine
    3. Sodium stibogluconate
    4. Paromomycin


  1. An HIV patient who was treated for VL twice before 9 months and 3 months ago, presented with another episode of VL again. He is on ART for the last nine months. This time he was treated with AmBisome (40mg/kg) and the test of cure from the spleen showed +4 LD bodies. The treatment was extended with AmBisome (30mg/kg) and miltefosine together and the end of one month treatment showed +5 LD bodies. Which one is better option of treatment for this patient?
    1. Better to stop antileishmania and observe
    2. ART should be changed
    3. Extend AmBisome plus miltefosine
    4. Treating with Sodium stibogluconate