title: Evaluation of the performance of four rapid tests for detection of hepatitis B surface antigen in Antananarivo, Madagascar.
abstract: Four rapid immunochromatographic assays--Determine HBsAg, Virucheck HBsAg, Cypress HBsAg Dipstick and Hexagon HBsAg--for human hepatitis B surface antigen (HBsAg) detection in human serum were evaluated. A collection of reference serum samples (91 HBsAg positive and 109 HBsAg negative) stored at -80 degrees C was used. Sensitivity and positive predictive value (PPV) exceeded 95%, and specificity and negative predictive value (NPV) exceeded 96% for all tests. The Determine HBsAg test performed best in this study, with a sensitivity of 97.8%, a specificity and PPV of 100%, a NPV of 98.2% and an accuracy rate of 99.0%. However, the differences between the tests were not significant. Other factors should therefore also be taken into account by the Ministry of Health in its decision to recommend a particular test: price, availability, delivery time and feasibility of whole-blood testing. The Determine test appears to be the most suitable for Madagascar, based on all these criteria. The use of this test, despite its lower sensitivity, could prevent blood-borne transmission of hepatitis B virus (HBV) in areas with limited resources.
authors.affiliation: Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Randrianirina
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Carod
authors.forename: Elisoa
authors.initials: E
authors.lastname: Ratsima
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Chrétien
authors.forename: Vincent
authors.initials: V
authors.lastname: Richard
authors.forename: Antoine
authors.initials: A
authors.lastname: Talarmin
mesh_terms: D001782:Blood Donors; D006509:Hepatitis B / Q000175:diagnosis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008270:Madagascar; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D006514:Hepatitis B Surface Antigens