title: [Human leptospirosis diagnosis:macroscopic agglutination test evaluation in different stages of the disease].
abstract: OBJECTIVE
  To evaluate the macroscopic agglutination test using Temperature Resistant (TR) antigen as a screening test for the diagnosis of human leptospirosis in different stages of the disease.
  
  
  METHODS
  The criteria for case definition were based on the results of the microscopic agglutination test (MAT), leukocyte counts and neutrophilia, resulting 218 confirmed cases and 242 non- cases. Each sample was classified according to the days of the disease progression in three stages: first (<10 days), second (10 - 25 days) and third (> 25 days). The design was cross-sectional observational.
  
  
  RESULTS
  TR sensitivity was 71,1% on stage 1. 93.4% on stage 2 and 95.6% on stage 3. The specificity at different stages ranged from 79.0 to 69.2%. Intra and inter-operator variability was moderate.
  
  
  CONCLUSIONS
  TR variability, low sensitivity in the first stage and low specificity found in all stages of the disease, suggest that it is essential to incorporate new diagnostic methods to screen for early detection of cases in our country and in countries that still apply such methods.
authors.affiliation: Instituto Nacional de Enfermedades Respiratorias, Dr. E. Coni, Blas Parera 8260, Santa Fe, Argentina. bibi_vanasco@hotmail.com
authors.forename: Norma Bibiana
authors.initials: NB
authors.lastname: Vanasco
authors.forename: María Fernanda
authors.initials: MF
authors.lastname: Schmeling
authors.forename: Yosena
authors.initials: Y
authors.lastname: Chiani
authors.forename: Javier
authors.initials: J
authors.lastname: Lottersberger
authors.forename: Héctor Dante
authors.initials: HD
authors.lastname: Tarabla
mesh_terms: D000372:Agglutination Tests; D000942:Antigens, Bacterial / Q000276:immunology; D001771:Blood Banks; D001793:Blood Preservation; D003430:Cross-Sectional Studies; D015925:Cryopreservation; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D007919:Leptospira / Q000276:immunology; D007922:Leptospirosis / Q000097:blood / Q000175:diagnosis*; D007958:Leukocyte Count; D008403:Mass Screening / Q000379:methods; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D000942:Antigens, Bacterial