Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal

Gautam, Rajendra; Parajuli, Keshab; Tshokey, Tshokey; Stenos, John; Sherchand, Jeevan Bahadur

doi:10.1186/s12879-020-4861-y

Cited by 25 publications

(8 citation statements)

References 17 publications

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“…Even though IgM-based immunofluorescence assay is a gold standard test for the diagnosis of scrub typhus, it has some drawbacks like its higher cost, the need for trained personal, and the requirement of a fluorescent microscope. So IgMbased ELISA may become a better alternate and possibly viable option for resource-limited endemic countries (Gautam et al 2020).…”

Section: Enzyme-linked Immunosorbent Assay (Igg and Igm)mentioning

confidence: 99%

Diagnosis of scrub typhus: recent advancements and challenges

et al. 2020

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Scrub typhus is a mite-borne, acute febrile illness caused by the bacterium Orientia tsutsugamushi. It is a re-emerging infectious disease of the tsutsugamushi triangle. Scrub typhus is transmitted through bites of contaminated chiggers (larval stage). Diagnosis of scrub typhus is challenging as its symptoms mimic with other acute febrile illnesses. Several methods are effectual for diagnosis of scrub typhus that includes enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), immunochromatographic test (ICT), Weil-Felix, polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). Weil-Felix test was initially used for the diagnosis of scrub typhus in underdeveloped countries but not preferred due to a lack of both specificity and sensitivity. Other immuno-based methods like IFA and ELISA are most outrank for detection of scrub typhus due to their higher sensitivity and specificity, but not vigorous to lay bare the infection at early stages and need the convalescent sampling for verification of positive samples. On another deed, PCR based methods becoming acceptable over era due to its dexterity of early-stage diagnosis with higher specificity and sensitivity but lack its applicability in circumstances of scrub typhus due to the variegated genetic makeup of Orientia tsutsugamushi among its serotypes. The present review focused on various detection methods along with their advantages and disadvantages used in the diagnosis of scrub typhus. A comparison between available methods of diagnosis with challenges in the detection of scrub typhus is also summarized.

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Section: Enzyme-linked Immunosorbent Assay (Igg and Igm)mentioning

confidence: 99%

Diagnosis of scrub typhus: recent advancements and challenges

et al. 2020

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“…In previous studies, 65.7–100% sensitivity and 72.5–95.5% specificity were reported for IgM ELISA; 66.2–91% sensitivity and 75–86.1% specificity were reported for IgG ELISA. IgM IFA showed 70–100% sensitivity and 83.8–93.5% specificity [ 16 , 42 , 43 ]. Our IgM ELISA is not inferior to the other assays in both sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

A Use of 56-kDa Recombinant Protein of Orientia tsutsugamushi Karp Serotype in Serodiagnosis of Scrub Typhus by Enzyme-Linked Immunosorbent Assay in Thais

et al. 2022

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Scrub typhus is a mite-borne disease caused by a Gram-negative obligately intracellular bacillus, Orientia tsutsugamushi. The disease is endemic in the Asia–Australia–Pacific region, including Thailand. Scrub typhus generally manifests as acute undifferentiated febrile fever along with myalgia, rash, and lymphadenopathy. An eschar can be a valuable diagnostic clue, but this skin lesion may be missed in some patients. The disease symptoms resemble those of other febrile illnesses such as leptospirosis, typhoid, murine typhus, malaria, and dengue fever, making a laboratory diagnosis necessary for the definitive diagnosis. In this study, we expressed a recombinant protein derived from 56-kDa type-specific antigen of O. tsutsugamushi Karp serotype and tested its ability to detect and differentiate scrub typhus infection. IgM and IgG antibodies were determined in sera from scrub typhus (n = 92) and other febrile illness patients (murine typhus (n = 25), melioidosis (n = 36), leptospirosis (n = 42), and dengue (n = 35)) from Thailand. Sensitivities of 87.0% and 59.8% with a specified assay cut-off were obtained for IgM and IgG indirect ELISAs, respectively, with a specificity of 100% in both tests. The sensitivity was increased to 95.7% when a combination of IgM and IgG ELISAs results was considered. Our study suggested a potential of the 56-kDa recombinant protein for further development and evaluation for use in scrub typhus serodiagnosis.

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“…The acute fever caused by the disease is often confused with other fever of unknown origin (FUO), such as typhoid fever, leptospirosis, dengue fever, malaria, and viral hemorrhagic fever. It is one of the important causes of FUO in endemic areas [13] .…”

Section: Discussionmentioning

confidence: 99%