title: Assessment of the efficacy of an IgM-elisa and microscopic agglutination test (MAT) in the diagnosis of acute leptospirosis.
abstract: In a prospective study in Barbados between 1979 and 1989, 321 cases were diagnosed in 638 patients presenting at a hospital with symptoms of leptospirosis. Initial diagnosis was based on patient history and characteristic signs and symptoms. In 92 cases (29%), diagnosis was confirmed by isolation of organisms from the blood, urine, or dialysate fluid; in the remaining 229 cases (71%) diagnosis was confirmed by serology alone. Results of an IgM-ELISA and microscopic agglutination test (MAT) in cases with isolates and in non-leptospirosis cases were used to assess the sensitivity and specificity of the tests. The sensitivity of IgM detection by ELISA was 52% in the first acute-phase specimen, increasing to 89% and 93% in the second acute-phase and convalescent specimens, respectively. The specificity of the IgM-ELISA was high (> or = 94%) in all specimens. The sensitivity of the MAT was low (30%) in the first acute-phase specimen, increasing to 63% in the second acute-phase specimen and 76% in the convalescent specimen. The specificity of the MAT was > or = 97% in all specimens.
authors.affiliation: Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Cumberland
authors.forename: C O
authors.initials: CO
authors.lastname: Everard
authors.forename: P N
authors.initials: PN
authors.lastname: Levett
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000372:Agglutination Tests / Q000592:standards*; D000907:Antibodies, Bacterial / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards*; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007919:Leptospira / Q000737:chemistry / Q000276:immunology / Q000302:isolation & purification*; D007922:Leptospirosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies
chemical_list: D000907:Antibodies, Bacterial; D007075:Immunoglobulin M