Key result
RDT demonstrates higher sensitivity than mIFA for early scrub typhus with ~3-fold higher IgM titers.
Why the study?
Does a rapid diagnostic test improve the detection of IgM and IgG antibodies to Orientia tsutsugamushi compared to microimmunofluorescence assay in scrub typhus patients?
Cross-Sectional (n=115)
Yes
Does a rapid diagnostic test improve the detection of IgM and IgG antibodies to Orientia tsutsugamushi compared to microimmunofluorescence assay in scrub typhus patients?
Absolute Event Rate: 113% vs 37%
p-value: p=<0.001
RDT is more sensitive than mIFA in the early diagnosis of scrub typhus and is particularly applicable in rural areas.
RDT may enable earlier scrub typhus detection in resource-limited settings; leaves open need for larger prospective validation against clinical outcomes.
OBJECTIVE: To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi (O. tsutsugamushi) by rapid diagnostic test (RDT) and microimmunofluorescence assay (mIFA). METHODS: RDT using a mixture of recombinant 56-kDa proteins of O. tsutsugamushi and mIFA assay were performed on 20 patients from Fujian and 13 patients from Yunnan Province, and 82 sera samples from healthy farmers in Anhui Province and Beijing City in 2009. Comparison of the RDT and mIFA assay was performed by using X(2) test and the P level of <0.05 was considered to be significance. RESULTS: Among these 82 normal sera samples, the specificity of RDT was 100% for both IgM and IgG tests. In 33 samples from patients with scrub typhus, 5 cases were positively detected earlier by RDT than by mIFA in IgM test, and 2 cases were positive in IgG test. Sensitivities of RDT were 93.9% and 90.9% for IgM and IgG, respectively. The sensitivity of combination test of IgM and IgG was 100%. Geometric mean titer diluted sera from confirmed cases by IFA and RDT assay were 1:37 vs. 1:113 (P<0.001) in IgM test and 1:99 vs. 1:279 (P<0.05) in IgG test. CONCLUSIONS: RDT is more sensitivite than mIFA in the early diagnosis of scrub typhus and it is particularly applicable in rural areas.
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Zhang et al. (2011) conducted a cross-sectional in Scrub typhus (n=115). Rapid diagnostic test (RDT) vs. Microimmunofluorescence assay (mIFA) was evaluated on Geometric mean titer for IgM antibodies (p=<0.001). A rapid diagnostic test demonstrated higher sensitivity than microimmunofluorescence assay for early diagnosis of scrub typhus, with significantly higher geometric mean titers for IgM (1:113 vs 1:37, P<0.001).
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