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.
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.
Ashraf
Hasan
H
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. ashrafh@icddrb.org
Beltinger
Johannes
J
Alam
Nur Haque
NH
Bardhan
Pradip Kumar
PK
Faruque
Abu Syed Golam
AS
Akter
Jesmin
J
Salam
Mohammed Abdus
MA
Gyr
Niklaus
N
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
D015415:Biomarkers; D007781:Lactoferrin