A recent
study aimed to assess the diagnostic accuracy of a rapid antibody detection
test using IgM immunochromatography for scrub typhus in children.
In this
cross-sectional, children aged 2 months to 18 years who were hospitalized with
undifferentiated fever lasting five days or more were enrolled over 18 months.
Blood samples were subjected to various serological tests, including –
Weil-Felix, Scrub IgM ELISA, immunofluorescence assay (IFA), and the rapid
diagnostic test (IgM Immunochromatography). The diagnostic accuracy of the
rapid test was evaluated against IFA – considered the gold standard.
The study
included 90 children, of whom 43 tested positive for scrub typhus with the gold
standard IFA. The rapid diagnostic test demonstrated a sensitivity of 88.3%, a
specificity of 89.3%, a positive predictive value (PPV) of 88.3%, and a
negative predictive value (NPV) of 89.3%. In comparison, the Weil-Felix test
exhibited a sensitivity of 39.5%, a specificity of 84.2%, a PPV of 58.6%, and
an NPV of 71.1%. The IgM ELISA showed a sensitivity of 93%, a specificity of
89.3%, a PPV of 88.8%, and an NPV of 93.3%.
Therefore, IgM immunochromatography demonstrated good diagnostic accuracy for scrub typhus in children with acute undifferentiated fever. It can be considered a reliable option for diagnosing scrub typhus in resource-limited settings where IFA is not readily available or is cost-prohibitive.
Source: Narayanappa
D, Geetha R, Rajani HS. Indian Pediatrics. 2023 Jul;60(7):546-8.
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