Comparative Assessment of the Gelatin Particle Agglutination Test and an Enzyme-Linked Immunosorbent Assay for Diagnosis of Strongyloidiasis

Sithithaworn, Jiraporn; Sithithaworn, Paiboon; Janrungsopa, T.; Suvatanadecha, K.; Ando, Katsuhiko; Haswell‐Elkins, Melissa

doi:10.1128/jcm.43.7.3278-3282.2005

Cited by 22 publications

(16 citation statements)

References 27 publications

(28 reference statements)

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“…The finding that no such cross reactivity for the closely related trematode, C . sinensis was observed in this study as well as the previous report [ 27 ] is currently not known, but confirmed analysis on a larger sample size is required. The diagnostic performance of antibody detection by the urine assay and serum assay compared with the primary reference standard shows 93% and 95% sensitivity respectively, however, PPV are low.…”

Section: Discussionsupporting

confidence: 88%

“…These findings are consistent with previous studies examining the prevalence of strongyloidiasis using serum ELISA in S . stercoralis endemic areas in Thailand by Douce and colleagues (45.0%) [ 7 ], by Sithithaworn and colleagues (47.5%) [ 10 ] and again by Sithithaworn and colleagues (27.5%) [ 27 ]. In Malaysia, serum ELISA detection showed that 31.5% prevalence in S .…”

Section: Discussionmentioning

confidence: 99%

“…stercoralis prevalence rate, as previously determined from our field studies in the S . stercoralis endemic areas in the region [ 27 ] to further characterize assay performance.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic performance of urinary IgG antibody detection: A novel approach for population screening of strongyloidiasis

et al. 2018

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The diagnosis of strongyloidiasis by coprological methods has a low sensitivity, underestimating the prevalence of Strongyloides stercoralis in endemic areas. Serodiagnostic tests for strongyloidiasis have shown robust diagnostic properties. However, these methods require a blood draw, an invasive and labor-intensive sample collection method, especially in the resource-limited settings where S. stercoralis is endemic. Our study examines a urine-based assay for strongyloidiasis and compares its diagnostic accuracy with coprological and serological methods. Receiver operating characteristic (ROC) curve analyses determined the diagnostic sensitivity (D-Sn) and specificity (D-Sp) of the urine ELISA, as well as estimates its positive predictive value and diagnostic risk. The likelihood ratios of obtaining a positive test result (LR+) or a negative test result (LR-) were calculated for each diagnostic positivity threshold. The urine ELISA assay correlated significantly with the serological ELISA assay for strongyloidiasis, with a D-Sn of 92.7% and a D-Sp of 40.7%, when compared to coprological methods. Moreover, the urine ELISA IgG test had a detection rate of 69%, which far exceeds the coprological method (28%). The likelihood of a positive diagnosis of strongyloidiasis by the urine ELISA IgG test increased significantly with increasing units of IgG detected in urine. The urine ELISA IgG assay for strongyloidiasis assay has a diagnostic accuracy comparable to serological assay, both of which are more sensitive than coprological methods. Since the collection of urine is easy and non-invasive, the urine ELISA IgG assay for strongyloidiasis could be used to screen populations at risk for strongyloidiasis in S. stercoralis endemic areas.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Diagnostic performance of urinary IgG antibody detection: A novel approach for population screening of strongyloidiasis

et al. 2018

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“…Therefore, a large amount of larvae is required for its performance. In order to overcome this drawback, Sato et al developed a gelatin particle agglutination (GPAT) test [86] and reported a sensitivity of 81% and a specificity of 74% [88]. Immunoblot analysis has been evaluated against immunodominant antigen of S.stercoralis and S.ratti , showing sensitivities between 65–100 [89], particularly higher when assessing IgG reactivity to a 41-KD [90] or 26 KDa larval component [91].…”

Section: Resultsmentioning

confidence: 99%

The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review

et al. 2013

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BackgroundStrongyloidiasis is frequently under diagnosed since many infections remain asymptomatic and conventional diagnostic tests based on parasitological examination are not sufficiently sensitive. Serology is useful but is still only available in reference laboratories. The need for improved diagnostic tests in terms of sensitivity and specificity is clear, particularly in immunocompromised patients or candidates to immunosuppressive treatments. This review aims to evaluate both conventional and novel techniques for the diagnosis of strongyloidiasis as well as available cure markers for this parasitic infection.Methodology/Principal FindingsThe search strategy was based on the data-base sources MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS and was limited in the search string to articles published from 1960 to August 2012 and to English, Spanish, French, Portuguese and German languages. Case reports, case series and animal studies were excluded. 2003 potentially relevant citations were selected for retrieval, of which 1649 were selected for review of the abstract. 143 were eligible for final inclusion.ConclusionsSensitivity of microscopic-based techniques is not good enough, particularly in chronic infections. Furthermore, techniques such as Baermann or agar plate culture are cumbersome and time-consuming and several specimens should be collected on different days to improve the detection rate. Serology is a useful tool but it might overestimate the prevalence of disease due to cross-reactivity with other nematode infections and its difficulty distinguishing recent from past (and cured) infections. To evaluate treatment efficacy is still a major concern because direct parasitological methods might overestimate it and the serology has not yet been well evaluated; even if there is a decline in antibody titres after treatment, it is slow and it needs to be done at 6 to 12 months after treatment which can cause a substantial loss to follow-up in a clinical trial.

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“…Recently, a dipstick assay was found to be easily and quickly performed and correlated well with ELISA results [38]. A gelatin particle agglutination test has been proposed as an alternative to ELISA for mass screening in endemic areas because of its low cost and convenience [39]. An immediate hypersensitivity skin test has been used in a research setting quite effectively, although it may have limited utility in HTLV-1-infected patients [40].…”

Section: Diagnosismentioning

confidence: 99%

Strongyloides stercoralis infection in the immunocompromised host

Ramanathan

Nutman²

2008

Curr Infect Dis Rep

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Strongyloides stercoralis is an intestinal nematode acquired in the tropics or subtropics. Most often, it causes chronic, asymptomatic infection, but a change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. Corticosteroid use is most commonly associated with hyperinfection syndrome. Diagnosis of Strongyloides infection is based on serology and serial stool examinations for larvae. The treatment of choice for chronic, asymptomatic infection is oral ivermectin. Alternative pharmacologic agents include albendazole and thiabendazole. For hyperinfection syndrome, ivermectin remains the drug of choice, though therapy duration must be individualized with the end point being complete parasite eradication. Recurrent strongyloidiasis should prompt an evaluation for human T-cell lymphotropic virus type 1 coinfection. No test of cure is currently available, although immunoglobulin G antibody levels have been shown to decline within 6 months of successful treatment.

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Comparative Assessment of the Gelatin Particle Agglutination Test and an Enzyme-Linked Immunosorbent Assay for Diagnosis of Strongyloidiasis

Cited by 22 publications

References 27 publications

Diagnostic performance of urinary IgG antibody detection: A novel approach for population screening of strongyloidiasis

Diagnostic performance of urinary IgG antibody detection: A novel approach for population screening of strongyloidiasis

The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review

Strongyloides stercoralis infection in the immunocompromised host

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