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Optimizing the microscopic agglutination test (MAT) panel for the diagnosis of Leptospirosis in a low resource, hyper-endemic setting with varied microgeographic variation in reactivity
- Source :
- PLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009565 (2021), PLoS Neglected Tropical Diseases
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- The microscopic agglutination test (MAT) is the standard serological reference test for the diagnosis of leptospirosis, despite being a technically demanding and laborious procedure. The use of a locally optimised MAT panel is considered essential for proper performance and interpretation of results. This paper describes the procedure of selecting such an optimised panel for Sri Lanka, a country hyper-endemic for leptospirosis. MAT was performed using 24 strains on 1132 serum samples collected from patients presenting with acute undifferentiated fever. Of 24 strains, 15 were selected as the optimised panel, while only 11% of serum samples showed positivity. A geographical variation in predominantly reactive serovars was observed, whereas reactivity was low with the saprophytic strain Patoc. Testing with paired sera yielded a higher sensitivity but provided only a retrospective diagnosis. Serological tests based on ELISA with complementary molecular diagnosis using PCR are a feasible and robust alternative approach to diagnose leptospirosis in countries having a higher burden of the disease.<br />Author summary Microscopic agglutination test is the most commonly used serological test in the diagnosis of leptospirosis. The test uses a live panel of Leptospira representing main serogroups and for proper performance of the test, an optimised panel which react well with patient samples need to be selected. This paper describes the procedure of selecting such an optimised panel for Sri Lanka which is a country hyper-endemic for leptospirosis. The test was done on serum samples collected from patients presented with acute undifferentiated fever with 24 panel of serogroups and 15 were selected as the optimised panel. The test was found to have a low sensitivity in the acute stage and ELISA based serological tests with molecular diagnosis using PCR assays would be a better way for diagnosis of leptospirosis.
- Subjects :
- Male
Bacterial Diseases
Serotype
Veterinary medicine
Endemic Diseases
Nosocomial Infections
RC955-962
Fevers
Pathology and Laboratory Medicine
Polymerase Chain Reaction
Serology
Medical Conditions
0302 clinical medicine
Zoonoses
Direct agglutination test
Arctic medicine. Tropical medicine
Medicine and Health Sciences
030212 general & internal medicine
Leptospira
Serodiagnosis
Middle Aged
Antibodies, Bacterial
Leptospirosis
Bacterial Pathogens
Leptospira Interrogans
Infectious Diseases
Medical Microbiology
Female
Pathogens
Public aspects of medicine
RA1-1270
Research Article
Neglected Tropical Diseases
Adult
Low resource
030231 tropical medicine
Enzyme-Linked Immunosorbent Assay
Biology
Sensitivity and Specificity
Microbiology
Young Adult
03 medical and health sciences
Reference test
Signs and Symptoms
Diagnostic Medicine
Agglutination Tests
medicine
Humans
Serologic Tests
Microbial Pathogens
Aged
Retrospective Studies
Sri Lanka
Bacteria
Organisms
Public Health, Environmental and Occupational Health
Biology and Life Sciences
Tropical Diseases
medicine.disease
Serum samples
Clinical Medicine
Sri lanka
Subjects
Details
- Language :
- English
- ISSN :
- 19352735 and 19352727
- Volume :
- 15
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....8068d361c0bebef29fe3227a311617e0