Watt G, Strickman D, Kantipong P, Jongsakul K, Paxton H
Department of Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
J Infect Dis. 1998 Mar;177(3):800-2. doi: 10.1086/517813.
A rapid dipstick test for scrub typhus was prospectively evaluated in Chiangrai, northern Thailand. Sera from 162 patients with fever of unclear etiology were tested by a dot blot immunoassay using two different antigen concentrations. Dipsticks coated with lower concentration of antigen lacked sensitivity compared with the indirect immunoperoxidase test. Dipsticks with higher antigen concentration had increased sensitivity that was equivalent to that of the immunoperoxidase test. By increasing the antigen concentration on the dipstick, sensitivity increased from 67% to 100%, positive predictive value increased from 90% to 93%, and negative predictive value rose from 92% to 100%. The specificity of both antigen concentrations was 98%. This study establishes that scrub typhus can be confirmed serologically by use of a dipstick assay and that serodiagnosis can be effectively tailored to a target population.
在泰国北部清莱对恙虫病快速检测试纸进行了前瞻性评估。对162例病因不明发热患者的血清采用两种不同抗原浓度通过斑点印迹免疫分析法进行检测。与间接免疫过氧化物酶试验相比，涂有较低浓度抗原的试纸缺乏敏感性。抗原浓度较高的试纸敏感性增加，与免疫过氧化物酶试验相当。通过增加试纸上的抗原浓度，敏感性从67%提高到100%，阳性预测值从90%提高到93%，阴性预测值从92%提高到100%。两种抗原浓度的特异性均为98%。本研究证实，恙虫病可通过试纸检测进行血清学确诊，并且血清学诊断可有效地针对目标人群。
