Scrub typhus diagnosis on acute specimens using serological and molecular assays — a 3-year prospective study

Koralur, Munegowda and Singh, Rahul and Varma, Muralidhar D and Shenoy, Shalini and Acharya, Vasudeva and Kamath, Asha and bairy, Indira and Stenos, John and Athan, Eugen (2018) Scrub typhus diagnosis on acute specimens using serological and molecular assays — a 3-year prospective study. Diagnostic Microbiology and Infectious Disease, 91 (1). pp. 112-117. ISSN 07328893

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Abstract

Scrubtyphus (ST) is anunderdiagnosed acute febrile illness in the Asia Pacific region with recent reemergence. Clinical diagnosis is difficult, and laboratory confirmation is largely based on serological and molecular tests. However, Weil–Felix test still remains the only test available inmuch of the rural tropics where a disproportionate number of cases occur. Sensitive and affordable assays are important for broader use and accurate diagnosis. We evaluated the diagnostic capabilities of serological and molecular assays on single acute clinical samples. Out of 1036 cases, 319 were confirmed as ST, and the sensitivities of immunofluorescent assay (IFA), IgM enzyme-linked immunosorbent assay (ELISA), nested polymerase chain reaction (n-PCR) and WFTwere 93.4%, 80.3%, 75.2%, and 54.2%, respectively. IgM ELISA + n-PCR combination demonstrated highest degree of agreement (κ =.911) in the absence of IFA. Additionally, 16 cases were detected by n-PCR only. Our study emphasizes the diagnostic challenges in the developing world, importance of molecular tests, and best alternate assays in ST diagnosis.

Item Type: Article
Uncontrolled Keywords: Scrub typhus diagnosis India Combination assays IFA PCR Weil–Felix test Seronegative stage
Subjects: Medicine > KMC Manipal > Community Medicine
Departments at MU > Statistics
Medicine > KMC Mangalore > Microbiology
Medicine > MMMC Maleka
Medicine > KMC Manipal > Medicine
Medicine > KMC Manipal > Microbiology
Depositing User: KMCMLR User
Date Deposited: 13 Jul 2018 09:36
Last Modified: 13 Jul 2018 09:36
URI: http://eprints.manipal.edu/id/eprint/151561

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