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-
1.
Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E, 2007. Serological evidence for wide distribution of spotted fevers and typhus fever in Tamil Nadu. Indian J Med Res 126: 128–130.
-
2.
Phongmany S, Rolain JM, Phetsouvanh R, Blacksell SD, Soukkhaseum V, Rasachack B, Phiasakha K, Soukkhaseum S, Frichithavong K, Chu V, Keolouangkhot V, Martinez-Aussel B, Chang K, Darasavath C, Rattanavong O, Sisouphone S, Mayxay M, Vidamaly S, Parola P, Thammavong C, Heuangvongsy M, Syhavong B, Raoult D, White NJ, Newton PN, 2006. Rickettsial infections and fever, Vientiane, Laos. Emerg Infect Dis 12: 256–262.
-
3.
Silpapojakul K, Pradutkanchana J, Pradutkanchana S, Kelly DJ, 1995. Rapid, simple serodiagnosis of murine typhus. Trans R Soc Trop Med Hyg 89: 625–628.
-
4.
Suttinont C, Losuwanaluk K, Niwatayakul K, Hoontrakul S, Intaranongpai W, Silpasakorn S, Suwancharoen D, Panlar P, Saisongkorh W, Rolain JM, Raoult D, Suputtamongkol Y, 2006. Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study. Ann Trop Med Parasitol 100: 363–370.
-
5.
Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25: 900–905.
-
6.
Tay ST, Kamalanathan M, Rohani MY, 2003. Antibody prevalence of Orientia tsutsugamushi, Rickettsia typhi and TT118 spotted fever group rickettsiae among Malaysian blood donors and febrile patients in the urban areas. Southeast Asian J Trop Med Public Health 34: 165–170.
-
7.
Coleman RE, Sangkasuwan V, Suwanabun N, Eamsila C, Mungviriya S, Devine P, Richards AL, Rowland D, Ching WM, Sattabongkot J, Lerdthusnee K, 2002. Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Am J Trop Med Hyg 67: 497–503.
-
8.
Day NP, Newton PN, 2010. Scrub Typhus and Other Tropical Rickettsioses. Cohen J, Powderly W, eds. Infectious Diseases. London: Mosby, in press.
-
9.
Ching WM, Rowland D, Zhang Z, Bourgeois AL, Kelly D, Dasch GA, Devine PL, 2001. Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. Clin Diagn Lab Immunol 8: 409–414.
-
10.
Watt G, Jongsakul K, Ruangvirayuth R, Kantipong P, Silpapojakul K, 2005. Short report: prospective evaluation of a multi-test strip for the diagnoses of scrub and murine typhus, leptospirosis, dengue fever, and Salmonella typhi infection. Am J Trop Med Hyg 72: 10–12.
-
11.
Kelly DJ, Chan CT, Paxton H, Thompson K, Howard R, Dasch GA, 1995. Comparative evaluation of a commercial enzyme immunoassay for the detection of human antibody to Rickettsia typhi. Clin Diagn Lab Immunol 2: 356–360.
-
12.
Saunders JP, Brown GW, Shirai A, Huxsoll DL, 1980. The longevity of antibody to Rickettsia tsutsugamushi in patients with confirmed scrub typhus. Trans R Soc Trop Med Hyg 74: 253–257.
-
13.
Blacksell SD, Bryant NJ, Paris DH, Doust JA, Sakoda Y, Day NP, 2007. Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion. Clin Infect Dis 44: 391–401.
-
14.
Parola P, Blacksell SD, Phetsouvanh R, Phongmany S, Rolain JM, Day NP, Newton PN, Raoult D, 2008. Genotyping of Orientia tsutsugamushi from humans with scrub typhus, Laos. Emerg Infect Dis 14: 1483–1485.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 469 | 426 | 32 |
| Full Text Views | 363 | 9 | 1 |
| PDF Downloads | 122 | 9 | 1 |
Accuracy of Rapid IgM-Based Immunochromatographic and Immunoblot Assays for Diagnosis of Acute Scrub Typhus and Murine Typhus Infections in Laos
Stuart D. Blacksell
Stuart D. Blacksell
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Kemajittra Jenjaroen
Kemajittra Jenjaroen
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Rattanaphone Phetsouvanh
Rattanaphone Phetsouvanh
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Ampai Tanganuchitcharnchai
Ampai Tanganuchitcharnchai
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Phonlavanh Phouminh
Phonlavanh Phouminh
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Simalee Phongmany
Simalee Phongmany
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Nicholas P. J. Day
Nicholas P. J. Day
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Paul N. Newton
Paul N. Newton
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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We studied the diagnostic accuracy of a rapid immunochromatographic test (ICT) for detection of IgM against scrub typhus (ST ICT) and an immunoblot test for the detection of IgM against murine typhus (MT IBT) by using admission serum samples from 1,030 febrile patients in Laos. Sensitivity and specificity for the ST ICT determined by using the diagnostic criteria of a four-fold increase in IgM against Orientia tsutsugamushi between paired samples were 23.8% (95% confidence interval [CI] = 15.9–33.3%) and 86.2% (95% CI = 84.1–88.6%), respectively. Sensitivity and specificity for the ST ICT determined by using an admission IgM titer ≥ 1:400 were 39.1% (95% CI = 34.1–44.2%) and 99.5% (95% CI = 98.7–99.9%), respectively. Sensitivity and specificity for the MT IBT determined by using the criteria of a four-fold increase in IgM against Rickettsia typhi between paired serum samples were 61.2% (95% CI = 53.7–68.3%) and 86.5% (95% CI = 84.1–88.8%), respectively. Sensitivity and specificity for the MT IBT determined by using an admission IgM titer ≥ 1:400 were 54.6% (95% CI = 49.1–60.0%) and 94.1% (95% CI = 92.0–95.7%), respectively. Both assays had relatively good specificity but low sensitivity and thus have limited utility for admission diagnosis.
Author Notes
Financial support: This study was supported by the Wellcome Trust of Great Britain.
Disclosure: The authors had no conflict of interest in conducting this study. The tests were provided without charge by PanBio Pty. Ltd. PanBio Pty. Ltd. had no role in the design, execution, analysis, writing, or submission of this report.
Authors' addresses: Stuart D. Blacksell, Nicholas P. J. Day, and Paul N. Newton, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Rajthevee, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom, and Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos, E-mails: stuart@tropmedres.ac, nickd@tropmedres.ac, and paul@tropmedres.ac. Kemajittra Jenjaroen and Ampai Tanganuchitcharnchai, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Rajthevee, Bangkok, Thailand, E-mails: ampai@tropmedres.ac and nickd@tropmedres.ac. Rattanaphone Phetsouvanh, Phonlavanh Phouminh, and Simalee Phongmany, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos, E-mail: rphetsouvanh@yahoo.co.uk.
Reprint requests: Stuart D. Blacksell. Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok 10400, Thailand, E-mail: stuart@tropmedres.ac.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E, 2007. Serological evidence for wide distribution of spotted fevers and typhus fever in Tamil Nadu. Indian J Med Res 126: 128–130.
-
2.
Phongmany S, Rolain JM, Phetsouvanh R, Blacksell SD, Soukkhaseum V, Rasachack B, Phiasakha K, Soukkhaseum S, Frichithavong K, Chu V, Keolouangkhot V, Martinez-Aussel B, Chang K, Darasavath C, Rattanavong O, Sisouphone S, Mayxay M, Vidamaly S, Parola P, Thammavong C, Heuangvongsy M, Syhavong B, Raoult D, White NJ, Newton PN, 2006. Rickettsial infections and fever, Vientiane, Laos. Emerg Infect Dis 12: 256–262.
-
3.
Silpapojakul K, Pradutkanchana J, Pradutkanchana S, Kelly DJ, 1995. Rapid, simple serodiagnosis of murine typhus. Trans R Soc Trop Med Hyg 89: 625–628.
-
4.
Suttinont C, Losuwanaluk K, Niwatayakul K, Hoontrakul S, Intaranongpai W, Silpasakorn S, Suwancharoen D, Panlar P, Saisongkorh W, Rolain JM, Raoult D, Suputtamongkol Y, 2006. Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study. Ann Trop Med Parasitol 100: 363–370.
-
5.
Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25: 900–905.
-
6.
Tay ST, Kamalanathan M, Rohani MY, 2003. Antibody prevalence of Orientia tsutsugamushi, Rickettsia typhi and TT118 spotted fever group rickettsiae among Malaysian blood donors and febrile patients in the urban areas. Southeast Asian J Trop Med Public Health 34: 165–170.
-
7.
Coleman RE, Sangkasuwan V, Suwanabun N, Eamsila C, Mungviriya S, Devine P, Richards AL, Rowland D, Ching WM, Sattabongkot J, Lerdthusnee K, 2002. Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Am J Trop Med Hyg 67: 497–503.
-
8.
Day NP, Newton PN, 2010. Scrub Typhus and Other Tropical Rickettsioses. Cohen J, Powderly W, eds. Infectious Diseases. London: Mosby, in press.
-
9.
Ching WM, Rowland D, Zhang Z, Bourgeois AL, Kelly D, Dasch GA, Devine PL, 2001. Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. Clin Diagn Lab Immunol 8: 409–414.
-
10.
Watt G, Jongsakul K, Ruangvirayuth R, Kantipong P, Silpapojakul K, 2005. Short report: prospective evaluation of a multi-test strip for the diagnoses of scrub and murine typhus, leptospirosis, dengue fever, and Salmonella typhi infection. Am J Trop Med Hyg 72: 10–12.
-
11.
Kelly DJ, Chan CT, Paxton H, Thompson K, Howard R, Dasch GA, 1995. Comparative evaluation of a commercial enzyme immunoassay for the detection of human antibody to Rickettsia typhi. Clin Diagn Lab Immunol 2: 356–360.
-
12.
Saunders JP, Brown GW, Shirai A, Huxsoll DL, 1980. The longevity of antibody to Rickettsia tsutsugamushi in patients with confirmed scrub typhus. Trans R Soc Trop Med Hyg 74: 253–257.
-
13.
Blacksell SD, Bryant NJ, Paris DH, Doust JA, Sakoda Y, Day NP, 2007. Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion. Clin Infect Dis 44: 391–401.
-
14.
Parola P, Blacksell SD, Phetsouvanh R, Phongmany S, Rolain JM, Day NP, Newton PN, Raoult D, 2008. Genotyping of Orientia tsutsugamushi from humans with scrub typhus, Laos. Emerg Infect Dis 14: 1483–1485.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 469 | 426 | 32 |
| Full Text Views | 363 | 9 | 1 |
| PDF Downloads | 122 | 9 | 1 |