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Assessment of the efficacy of an IgM-elisa and microscopic agglutination test (MAT) in the diagnosis of acute leptospirosis.

Abstract
In a prospective study in Barbados between 1979 and 1989, 321 cases were diagnosed in 638 patients presenting at a hospital with symptoms of leptospirosis. Initial diagnosis was based on patient history and characteristic signs and symptoms. In 92 cases (29%), diagnosis was confirmed by isolation of organisms from the blood, urine, or dialysate fluid; in the remaining 229 cases (71%) diagnosis was confirmed by serology alone. Results of an IgM-ELISA and microscopic agglutination test (MAT) in cases with isolates and in non-leptospirosis cases were used to assess the sensitivity and specificity of the tests. The sensitivity of IgM detection by ELISA was 52% in the first acute-phase specimen, increasing to 89% and 93% in the second acute-phase and convalescent specimens, respectively. The specificity of the IgM-ELISA was high (> or = 94%) in all specimens. The sensitivity of the MAT was low (30%) in the first acute-phase specimen, increasing to 63% in the second acute-phase specimen and 76% in the convalescent specimen. The specificity of the MAT was > or = 97% in all specimens.
AuthorsP Cumberland, C O Everard, P N Levett
JournalThe American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 61 Issue 5 Pg. 731-4 (Nov 1999) ISSN: 0002-9637 [Print] United States
PMID10586903 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Bacterial
  • Immunoglobulin M
Topics
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Agglutination Tests (standards)
  • Antibodies, Bacterial (blood)
  • Enzyme-Linked Immunosorbent Assay (standards)
  • Female
  • Humans
  • Immunoglobulin M (blood)
  • Leptospira (chemistry, immunology, isolation & purification)
  • Leptospirosis (blood, diagnosis, immunology)
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Seroepidemiologic Studies

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