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

journal contribution
posted on 2018-06-01, 00:00 authored by M Koralur, R Singh, M Varma, S Shenoy, V Acharya, A Kamath, J Stenos, Eugene AthanEugene Athan, I Bairy
Scrub typhus (ST) is an underdiagnosed 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 in much 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 WFT were 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.

History

Journal

Diagnostic microbiology and infectious disease

Volume

91

Pagination

112-117

Location

Amsterdam, The Netherlands

ISSN

0732-8893

eISSN

1879-0070

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, Elsevier

Issue

2

Publisher

Elsevier

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