The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh

Maude, Rapeephan R, de Jong, Hanna K, Wijedoru, Lalith, Fukushima, Masako, Ghose, Aniruddha, Samad, Rasheda, Hossain, Mohammed Amir, Karim, Mohammed Rezaul, Faiz, Mohammed Abul and Parry, Christopher (2015) 'The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh'. Tropical Medicine & International Health, Vol 20, Issue 10, pp. 1376-1384.

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Abstract

Objective:
To determine the diagnostic accuracy of three rapid diagnostic tests (RDTs) for typhoid fever in febrile hospitalised patients in Bangladesh.

Methods:
Febrile adults and children admitted to Chittagong Medical College Hospital, Bangladesh, were investigated with Bact/Alert® blood cultures and real-time PCR to detect Salmonella enterica Typhi and Paratyphi A and assays for Rickettsia, leptospirosis and dengue fever. Acute serum samples were examined with the LifeAssay (LA) Test-it™ Typhoid IgM lateral flow assay detecting IgM antibodies against S. Typhi O antigen, CTKBiotech Onsite Typhoid IgG/IgM Combo Rapid-test cassette lateral flow assay detecting IgG and IgM antibodies against S. Typhi O and H antigens and SD Bioline line assay for IgG and IgM antibodies against S. Typhi proteins.

Results:
In 300 malaria smear-negative febrile patients [median (IQR) age of 13.5 (5–31) years], 34 (11.3%) had confirmed typhoid fever: 19 positive by blood culture for S. Typhi (three blood PCR positive) and 15 blood culture negative but PCR positive for S. Typhi in blood. The respective sensitivity and specificity of the three RDTs in patients using a composite reference standard of blood culture and/or PCR-confirmed typhoid fever were 59% and 61% for LifeAssay, 59% and 74% for the CTK IgM and/or IgG, and 24% and 96% for the SD Bioline RDT IgM and/or IgG. The LifeAssay RDT had a sensitivity of 63% and a specificity of 91% when modified with a positive cut-off of ≥2+ and analysed using a Bayesian latent class model.

Conclusions:
These typhoid RDTs demonstrated moderate diagnostic accuracies, and better tests are needed.

Item Type:	Article
Corporate Authors:	CMCH Typhoid Study Group
Subjects:	QY Clinical Pathology > Blood. Blood Chemistry > QY 400 General works WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General) 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/10.1111/tmi.12559
Depositing User:	Jessica Jones
Date Deposited:	26 Jan 2016 11:17
Last Modified:	06 Feb 2018 13:11
URI:	https://archive.lstmed.ac.uk/id/eprint/5532

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