title: Diagnostic Accuracy Assessment of Immunochromatographic Tests for the Rapid Detection of Antibodies Against Orientia tsutsugamushi Using Paired Acute and Convalescent Specimens.
abstract: We assessed the diagnostic accuracy of two immunochromatographic tests (ICTs), the Access Bio CareStart Scrub Typhus test (Somerset, NJ) (IgM), and the SD BIOLINE Tsutsugamushi test (Kyonggi-do, Republic of Korea) (IgG, IgM, or IgA) compared with indirect immunofluorescence assay (IFA) and real-time PCR results as reference tests using 86 paired acute and convalescent specimens from febrile patients. The sensitivity and specificity of the CareStart test were 23.3% (95% confidence interval [CI]: 11.8-38.6) and 81.4% (95% CI: 66.6-91.6), respectively, for acute specimens and 32.6% (95% CI: 19.1-48.5) and 79.1% (95% CI: 64.0-90.0), respectively, for convalescent specimens. For the SD BIOLINE test, sensitivity and specificity were 20.9% (95% CI: 10.0-36.0) and 74.4% (95% CI: 58.8-86.5), respectively, for acute specimens and 76.7% (95% CI: 61.4-88.2) and 76.7% (95% CI: 61.4-88.2), respectively, for convalescent specimens. The poor sensitivity obtained for both ICTs during this study when performed on acute specimens highlights the difficulties in prompt diagnosis of scrub typhus.
authors.forename: Wanitda
authors.initials: W
authors.lastname: Watthanaworawit
authors.forename: Paul
authors.initials: P
authors.lastname: Turner
authors.forename: Claudia
authors.initials: C
authors.lastname: Turner
authors.forename: Ampai
authors.initials: A
authors.lastname: Tanganuchitcharnchai
authors.forename: Suthatip
authors.initials: S
authors.lastname: Jintaworn
authors.forename: Borimas
authors.initials: B
authors.lastname: Hanboonkunupakarn
authors.forename: Allen L
authors.initials: AL
authors.lastname: Richards
authors.forename: Nicholas P J
authors.initials: NPJ
authors.lastname: Day
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Blacksell
authors.forename: François
authors.initials: F
authors.lastname: Nosten
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000276:immunology*; D002846:Chromatography, Affinity / Q000379:methods*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D012285:Orientia tsutsugamushi / Q000276:immunology*; D060888:Real-Time Polymerase Chain Reaction; D012612:Scrub Typhus / Q000175:diagnosis* / Q000276:immunology; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial