Free Content Rapid diagnostic tests for dengue and leptospirosis: antibody detection is insensitive at presentation

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Abstract:

Summary Objective  To determine the performance of rapid diagnostic tests for dengue and leptospirosis that rely on detecting antibodies that may not be produced when patients present for medical treatment. Methods  We prospectively enrolled 723 patients with undifferentiated febrile illness presenting to rural hospitals in northern and northeastern Thailand over a 1-year period. We evaluated rapid antibody detection diagnostic tests for dengue and leptospirosis on these patients. Results  Sensitivity of the tests was low at the acute visit (7.6–21.5%). Sensitivity at the convalescent visit ranged from 25.8% to 81.5% and was significantly higher than at the acute visit for all tests (,  < 0.001). Conclusions  Low sensitivity of the rapid tests at presentation suggests that their utility in the acute phase of dengue and leptospirosis is limited.

French
Objectifs 

Déterminer si les tests rapides de diagnostic de la dengue et de la leptospirose détectent des anticorps non-produits au moment où les patients se présentent pour un traitement médical. Méthodes 

Nous avons enrôlée prospectivement 723 patients avec des maladies fébriles indistincts se présentant dans un hôpital rural du nord-est de la Thaïlande sur une période de un an. Nous avons évalué des tests rapides de diagnostic basés sur la détection d'anticorps de la dengue et de la leptospirose. Résultats 

La sensibilité de ces tests était basse durant la phase aigue, à la visite du patient (7.6 à 21.5%). La sensibilité au moment de la convalescence allait de 24.8 à 81.5% et était significativement plus élevée que lors de phage aigue à la visite, pour tous les tests (χ 2, P < 0.001). Conclusions 

La sensitivité basse de ces tests rapides au moment de la présentation des patients suggère leur utilité limitée durant la phase aigue de la dengue et de la leptospirose.

Keywords: dengue; diagnostic tests; leptoespirosis; leptospirose; leptospirosis; medicina tropical; médecine tropicale; prueba diagnóstica; tests de diagnostic; tropical medicine

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2006.01752.x

Affiliations: 1:  Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA 2:  International Emerging Infections Program, Thai Ministry of Public Health-Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand 3:  Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand 4:  Thailand National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand

Publication date: January 1, 2007

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