title: Evaluation of faecal occult blood test and lactoferrin latex agglutination test in screening hospitalized patients for diagnosing inflammatory and non-inflammatory diarrhoea in Dhaka, Bangladesh.
abstract: BACKGROUND
  Inflammatory diarrhoea (ID) resulting from Shigella, Salmonella, Campylobacter and Entamoeba histolytica requires specific diagnosis for therapy. Differentiation between ID and non-inflammatory diarrhoea (NID) is often not clinically possible. A faecal occult blood test (FOBT) correlates with faecal leucocytes. Lactoferrin indicates an inflammatory process as a marker for faecal leucocytes. We evaluated diagnostic values of lactoferrin latex agglutination test (LT) either alone or in combination with FOBT, correlating with stool microscopy and microbiology in differentiating ID from NID.
  
  
  METHODS
  The study population constituted patients enrolled in 2% systematic sampling of patients under Diarrhoeal Disease Surveillance System of Dhaka Hospital, ICDDR,B.
  
  
  RESULTS
  Between July and November 2002, 594 patients were enrolled; evaluation of FOBT and LT were done in 448/594 (75%) patients from whom either a single enteropathogen (315/594, 53%) or no pathogen (133/594, 22%) were identified and 146 were excluded for multiple pathogens. Invasive and non-invasive pathogens were isolated from 24% and 76% of the patients. FOBT and LT were positive in 40% and 39% of the samples. The sensitivities, specificities, PPVs, NPVs, and accuracies of FOBT were 55, 63, 24, 87 and 62%, and LT were 52, 64, 23, 86 and 62%, respectively.
  
  
  CONCLUSIONS
  FOBT and LT are not useful in differentiating ID from NID in diarrhoeal patients in Dhaka, Bangladesh.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. ashrafh@icddrb.org
authors.forename: Hasan
authors.initials: H
authors.lastname: Ashraf
authors.forename: Johannes
authors.initials: J
authors.lastname: Beltinger
authors.forename: Nur Haque
authors.initials: NH
authors.lastname: Alam
authors.forename: Pradip Kumar
authors.initials: PK
authors.lastname: Bardhan
authors.forename: Abu Syed Golam
authors.initials: AS
authors.lastname: Faruque
authors.forename: Jesmin
authors.initials: J
authors.lastname: Akter
authors.forename: Mohammed Abdus
authors.initials: MA
authors.lastname: Salam
authors.forename: Niklaus
authors.initials: N
authors.lastname: Gyr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology*; D004403:Dysentery / Q000175:diagnosis* / Q000382:microbiology; D005243:Feces / Q000737:chemistry / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007781:Lactoferrin / Q000032:analysis*; D008853:Microscopy; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D007781:Lactoferrin