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Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard

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Moore, C. E., Pan-Ngum, W., Wijedoru, L. P. M., Sona, S., Nga, T. V. T., Duy, P. T., Vinh, P. V., Chheng, K., Kumar, V., Emary, K., Carter, M., White, L., Baker, S., Day, N. P. J. and Parry, Christopher (2014) 'Evaluation of the Diagnostic Accuracy of a Typhoid IgM Flow Assay for the Diagnosis of Typhoid Fever in Cambodian Children Using a Bayesian Latent Class Model Assuming an Imperfect Gold Standard'. American Journal of Tropical Medicine and Hygiene, Vol 90, Issue 1, pp. 114-120.

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Abstract

Rapid diagnostic tests are needed for typhoid fever (TF) diagnosis in febrile children in endemic areas. Five hundred children admitted to the hospital in Cambodia between 2009 and 2010 with documented fever (≥ 38°C) were investigated using blood cultures (BCs), Salmonella Typhi/Paratyphi A real-time polymerase chain reactions (PCRs), and a Typhoid immunoglobulin M flow assay (IgMFA). Test performance was determined by conventional methods and Bayesian latent class modeling. There were 32 cases of TF (10 BC- and PCR-positive cases, 14 BC-positive and PCR-negative cases, and 8 BC-negative and PCR-positive cases). IgMFA sensitivity was 59.4% (95% confidence interval = 41–76), and specificity was 97.8% (95% confidence interval = 96–99). The model estimate sensitivity for BC was 81.0% (95% credible interval = 54–99). The model estimate sensitivity for PCR was 37.8% (95% credible interval = 26–55), with a specificity of 98.2% (95% credible interval = 97–99). The model estimate sensitivity for IgMFA (≥ 2+) was 77.9% (95% credible interval = 58–90), with a specificity of 97.5% (95% credible interval = 95–100). The model estimates of IgMFA sensitivity and specificity were comparable with BCs and better than estimates using conventional analysis.

Item Type: Article
Subjects: QY Clinical Pathology > Diagnostic Tests > QY 250 Immunodiagnostic tests
QY Clinical Pathology > QY 4 General works
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 270 Typhoid fever
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.4269/ajtmh.13-0384
Depositing User: Lynn Roberts-Maloney
Date Deposited: 19 Sep 2014 12:19
Last Modified: 06 Feb 2018 13:07
URI: http://archive.lstmed.ac.uk/id/eprint/4448

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