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The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh


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Title: The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh
Authors: Maude, Rapeephan R. / de Jong, Hanna K. / Wijedoru, Lalith / Fukushima, Masako / Ghose, Aniruddha / Samad, Rasheda / Hossain, Mohammed Amir / Karim, Mohammed Rezaul / Faiz, Mohammed Abul / Parry, Christopher M.
Issue Date: Oct-2015
Publisher: Wiley-Blackwell
Citation: Tropical Medicine & International Health, 20(10), pp.1376-1384; 2015
Abstract: Objective: To determine the diagnostic accuracy of three rapid diagnostic tests (RDTs) for typhoid fever in febrile hospitalised patients in Bangladesh. Methods: Febrile adults and children admitted to Chittagong Medical College Hospital, Bangladesh, were investigated with Bact/Alert® blood cultures and real-time PCR to detect Salmonella enterica Typhi and Paratyphi A and assays for Rickettsia, leptospirosis and dengue fever. Acute serum samples were examined with the LifeAssay (LA) Test-it™ Typhoid IgM lateral flow assay detecting IgM antibodies against S. Typhi O antigen, CTKBiotech Onsite Typhoid IgG/IgM Combo Rapid-test cassette lateral flow assay detecting IgG and IgM antibodies against S. Typhi O and H antigens and SD Bioline line assay for IgG and IgM antibodies against S. Typhi proteins. Results: In 300 malaria smear-negative febrile patients [median (IQR) age of 13.5 (5-31) years], 34 (11.3%) had confirmed typhoid fever: 19 positive by blood culture for S. Typhi (three blood PCR positive) and 15 blood culture negative but PCR positive for S. Typhi in blood. The respective sensitivity and specificity of the three RDTs in patients using a composite reference standard of blood culture and/or PCR-confirmed typhoid fever were 59% and 61% for LifeAssay, 59% and 74% for the CTK IgM and/or IgG, and 24% and 96% for the SD Bioline RDT IgM and/or IgG. The LifeAssay RDT had a sensitivity of 63% and a specificity of 91% when modified with a positive cut-off of ≥2+ and analysed using a Bayesian latent class model. Conclusions: These typhoid RDTs demonstrated moderate diagnostic accuracies, and better tests are needed.
Keywords: Blood culture / Diagnostic accuracy / Rapid diagnostic tests / Real-time PCR / Salmonella enterica serovar Typhi / Typhoid fever
URI: http://hdl.handle.net/10069/35874
ISSN: 13602276
DOI: 10.1111/tmi.12559
Rights: © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd. / This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/35874

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