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dc.contributor.authorGautam, Rajendra
dc.contributor.authorParajuli, Keshab
dc.contributor.authorTshokey, Tshokey
dc.contributor.authorStenos, John
dc.contributor.authorSherchand, Jeevan Bahadur
dc.date.accessioned2020-08-03T05:11:06Z
dc.date.available2020-08-03T05:11:06Z
dc.date.issued2020
dc.identifier.issn1471-2334
dc.identifier.doi10.1186/s12879-020-4861-y
dc.identifier.urihttp://hdl.handle.net/10072/396087
dc.description.abstractBACKGROUND: Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium, Orientia tsutsugamushi. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. METHOD: Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit and an in-house IgM IFA. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. RESULT: Statistical analysis of IgM ELISA results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73-87.68%), specificity 94.82% (95% CI: 93.43-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06 -24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27-96.38%) respectively. CONCLUSION: Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofissue1
dc.relation.ispartofjournalBMC Infectious Diseases
dc.relation.ispartofvolume20
dc.subject.fieldofresearchMicrobiology
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchMedical Microbiology
dc.subject.fieldofresearchcode0605
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1108
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsInfectious Diseases
dc.subject.keywordsScrub typhus
dc.subject.keywordsELISA
dc.titleDiagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationGautam, R; Parajuli, K; Tshokey, T; Stenos, J; Sherchand, JB, Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal, BMC Infectious Diseases, 2020, 20 (1)
dcterms.dateAccepted2020-02-06
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2020-08-03T05:08:44Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s). 2020. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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gro.griffith.authorStenos, John


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