title: Evaluation of a newly developed dipstick test for the rapid diagnosis of scrub typhus in febrile patients.
abstract: Scrub typhus is a potentially fatal, febrile disease prevalent in rural Asia. The etiological agent, Orientia tsutsugamushi, is transmitted to humans by the bite of a larval trombiculid mite. No current diagnostic test is sufficiently practical for use by physicians working in rural areas. A new dipstick test using a dot blot immunoassay format has been developed for the serodiagnosis of scrub typhus. We evaluated this test on 83 patients presenting with acute fever of unknown origin at Maharaj Hospital, a tertiary care medical center in Nakhon Ratchasima, Northeast Thailand. The diagnosis of scrub typhus was confirmed in 30 of these patients (36%) by the indirect immunoperoxidase test. The sensitivity of the test was 87% and its specificity was 94%. The dot blot immunoassay dipstick is accurate, rapid, easy to use, and relatively inexpensive. It appears to be the best currently available test for diagnosing scrub typhus in rural areas where this disease predominates.
authors.affiliation: Department of Medicine, Maharaj Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Chinprasatsak
authors.forename: P
authors.initials: P
authors.lastname: Wilairatana
authors.forename: S
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: F
authors.initials: F
authors.lastname: Chappuis
authors.forename: K
authors.initials: K
authors.lastname: Akkhavong
authors.forename: H
authors.initials: H
authors.lastname: Laferl
authors.forename: C
authors.initials: C
authors.lastname: Eamsila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002701:Chloramphenicol / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013754:Tetracyclines / Q000627:therapeutic use; D013785:Thailand / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D011933:Reagent Kits, Diagnostic; D013754:Tetracyclines; D002701:Chloramphenicol; D004318:Doxycycline