SkiptomaincontentAdvertisementSearchallBMCarticlesSearchDownloadPDFResearcharticleOpenAccessPublished:13February2020DiagnosticevaluationofIgMELISAandIgMImmunofluorescenceassayforthediagnosisofAcuteScrubTyphusincentralNepalRajendraGautam1,KeshabParajuli1,TshokeyTshokey2,JohnStenos2&JeevanBahadurSherchand1 BMCInfectiousDiseasesvolume 20,Article number: 138(2020)Citethisarticle2934Accesses5CitationsMetricsdetailsAbstractBackgroundScrubtyphusisanacutefebrileillnesscausedbytheobligateintracellularbacterium,Orientiatsutsugamushi.Immunochromatography(ICT)andIgMELISAaretwooftheroutinelyemployedantibodybasedassaysfordiagnosisofScrubtyphusfeverinNepal,althoughtherecommendedgoldstandarddiagnostictestisIgMImmunofluorescenceassay(IFA).ThisstudyevaluatedInBiosScrubTyphusDetect™ImmunoglobulinM(IgM)ELISAandIgMImmunofluorescenceassaysinsingleserumsampleatthetimeofadmission.MethodStudyparticipants(1585suspectedcases),wereenrolledbasedonacutefebrileillnesswithsuspectedscrubtyphuscasesincentralNepal.Bloodsamplewascollectedfromthesuspectedpatientsofscrubtyphus,presentingwithacutefebrileillness.IgMantibodytoOrientiatsusugamushiwasdetectedbyusingScrubTyphusDetect™Kitandanin-houseIgMIFA.TheIFAassaywasperformedwiththeGilliam,Karp,KatostrainsandO.chutoantigensfollowingtheARRLprotocol.ResultStatisticalanalysisofIgMELISAresultswhencomparedtoreferencetest,IgMIFAresultsdemonstratedthefollowingcharacteristics,sensitivity84.0%(95%CI:79.73–87.68%),specificity94.82%(95%CI:93.43–95.99%),positivelikelihoodratio16.21%(95%CI:12.71–20.67%),negativelikelihoodratio0.17%(95%CI:0.13–0.21%),diseaseprevalence22.08%(95%CI:20.06-24.21%),positivepredictivevalue82.12%(95%CI:78.28–85.42%)andnegativepredictivevalue95.44%(95%CI:94.27–96.38%)respectively.ConclusionAlthoughIgMIFAisconsideredthegoldstandardtestforthediagnosisofscrubtyphuscases,itisrelativelyexpensive,requirestrainedpersonalandamicroscopewithfluorescencefilters.ScrubtyphusIgMELISAmaybethebestalternativetestandpossibleviableoptionforresourcelimitedendemic