Development of New, Broadly Reactive, Rapid IgG and IgM Lateral Flow Assays for Diagnosis of Scrub Typhus

Silpasakorn, Saowaluk; Srisamut, Nujorn; Ekpo, Pattama; Zhang, Zhiwen; Chao, Chien‐Chung; Ching, Wei‐Mei; Suputtamongkol, Yupin

doi:10.4269/ajtmh.2012.11-0583

Cited by 25 publications

(18 citation statements)

References 14 publications

(19 reference statements)

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“…Multiple groups have evaluated these LFTs. Although satisfactory clinical performance was observed in general, [28][29][30][31][32] it is worth noting that the manufacturing of these tests requires a specially equipped facility. On the contrary, the making of dot-ELISA plate needs neither special equipment nor facility, and any laboratory with the supply of recombinant proteins can prepare the dot-ELISA plate.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Clinical manifestations of scrub typhus vary widely from a mild and self-limiting febrile illness to a more severe illness that may be fatal. 4 Traditionally, the diagnosis of scrub typhus mainly relies on serologic tests. The disease could be diagnosed retrospectively in cases of seroconversion or a more than fourfold rise in antibody titers between acute-and convalescent-phase serum specimens.…”

Section: Introductionmentioning

confidence: 99%

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Dot-ELISA Rapid Test Using Recombinant 56-kDa Protein Antigens for Serodiagnosis of Scrub Typhus

Rodkvamtook¹,

Zhang²,

Chao³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. We developed a rapid dot-enzyme-linked immunosorbent assay (dot-ELISA) using the combination of recombinant 56-kDa protein antigens that exhibited broad reactivity with serum antibodies against the four most prevalent strains (Karp, Kato, Gilliam, and TA763) of Orientia tsutsugamushi. The assay is rapid (30 minutes), and can be done at room temperature, and results can be read by the naked eye. Only a simple shaker is required to wash the membrane. Sera from 338 patients suspected of being ill with scrub typhus from rural hospitals around Thailand were tested using this dot-ELISA. Seventy-five (22.2%) patients were found to be positive. The sensitivity and specificity of dot-ELISA were determined using the indirect immunofluorescent assay (IFA) test as the gold standard, with the cutoff titer of immunoglobulin peroxidase conjugate M (IgM)/G (IgG) greater than 1:400/1:400. The dot-ELISA had a sensitivity of 98.5%, a specificity of 96.3%, a positive predictive value of 86.7%, and a negative predictive value of 99.6% for the acutephase specimens. The results indicate that dot-ELISA rapid test using recombinant 56-kDa protein antigen was comparable with the IFA test and may be very useful for the diagnosis of scrub typhus in rural hospitals, where IFA is not available.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dot-ELISA Rapid Test Using Recombinant 56-kDa Protein Antigens for Serodiagnosis of Scrub Typhus

Rodkvamtook¹,

Zhang²,

Chao³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…scrub typhus), but most often relies on the detection of specific antibodies, generally on paired samples. Serological RDTs have been developed and validated for scrub typhus only, with very variable sensitivity estimates (39–97%) . Rapid diagnostic tests are in development for melioidosis, an infection due to Burkholderia pseudomallei that is a frequent cause of febrile illness and sepsis in southeastern Asia and northem Australia.…”

Section: Diseasesmentioning

confidence: 99%

Rapid diagnostic tests for non-malarial febrile illness in the tropics

Chappuis

Alirol

D’Acremont

et al. 2013

Clinical Microbiology and Infection

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The recent roll-out of rapid diagnostic tests (RDTs) for malaria has highlighted the decreasing proportion of malaria-attributable illness in endemic areas. Unfortunately, once malaria is excluded, there are few accessible diagnostic tools to guide the management of severe febrile illnesses in low resource settings. This review summarizes the current state of RDT development for several key infections, including dengue fever, enteric fever, leptospirosis, brucellosis, visceral leishmaniasis and human African trypanosomiasis, and highlights many remaining gaps. Most RDTs for non-malarial tropical infections currently rely on the detection of host antibodies against a single infectious agent. The sensitivity and specificity of host-antibody detection tests are both inherently limited. Moreover, prolonged antibody responses to many infections preclude the use of most serological RDTs for monitoring response to treatment and/or for diagnosing relapse. Considering these limitations, there is a pressing need for sensitive pathogen-detection-based RDTs, as have been successfully developed for malaria and dengue. Ultimately, integration of RDTs into a validated syndromic approach to tropical fevers is urgently needed. Related research priorities are to define the evolving epidemiology of fever in the tropics, and to determine how combinations of RDTs could be best used to improve the management of severe and treatable infections requiring specific therapy.

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“…Anti- O. tsutsugamushi IgG can persist leading to high RDT false-positive rates in endemic areas, for which assay adjustments might be required. Currently available RDTs are immunochromatographic or semiquantitative dot-blot assays, increasingly incorporating recombinant antigens, allowing greater standardization, and simple readout for point-of-care testing in resource-constrained settings [ 16 , 35 – 38 ].…”

Section: Scrub Typhus Nucleic Acid Amplification Testsmentioning

confidence: 99%

State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus

Paris

Dumler

2016

Current Opinion in Infectious Diseases

148

100

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Purpose of reviewWith improved malaria control, acute undifferentiated febrile illness studies in tropical regions reveal a startling proportion of rickettsial illnesses, especially scrub typhus, murine typhus, and spotted fever group rickettsioses. Laboratory diagnosis of these infections evolved little over the past 40 years, but combinations of technologies like PCR and loop-mediated isothermal amplification, with refined rapid diagnostic tests and/or ELISA, are promising for guidance for early antirickettsial treatment.Recent findingsThe long-term reliance on serological tests – useful only late in rickettsial infections – has led to underdiagnosis, inappropriate therapies, and undocumented morbidity and mortality. Recent approaches integrate nucleic acid amplification and recombinant protein-based serological tests for diagnosing scrub typhus. Optimized using Bayesian latent class analyses, this strategy increases diagnostic confidence and enables early accurate diagnosis and treatment – a model to follow for lagging progress in murine typhus and spotted fever.SummaryA laboratory diagnostic paradigm shift in rickettsial infections is evolving, with replacement of indirect immunofluorescence assay by the more objective ELISA coupled with nucleic acid amplification assays to expand the diagnostic window toward early infection intervals. This approach supports targeted antirickettsial therapy, reduces morbidity and mortality, and provides a robust evidence base for further development of diagnostics and vaccines.

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Development of New, Broadly Reactive, Rapid IgG and IgM Lateral Flow Assays for Diagnosis of Scrub Typhus

Cited by 25 publications

References 14 publications

Dot-ELISA Rapid Test Using Recombinant 56-kDa Protein Antigens for Serodiagnosis of Scrub Typhus

Dot-ELISA Rapid Test Using Recombinant 56-kDa Protein Antigens for Serodiagnosis of Scrub Typhus

Rapid diagnostic tests for non-malarial febrile illness in the tropics

State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus

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