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Sadaow L, Boonroumkaew P, Rodpai R, Sanpool O, Prasongdee P, Intapan PM, Maleewong W. High prevalence of anti-Strongyloides antibody in SARS-CoV-2-infected human sera in a Thai hospital: Rapid serological screening. J Infect Public Health 2024; 17:102466. [PMID: 38879920 DOI: 10.1016/j.jiph.2024.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can stimulate a systemic inflammatory response with severe lung involvement, multisystem dysfunction, and death in some cases. Immunosuppressive treatments have been proposed for management of COVID-19 patients, but these bring the risk of flare-up of pre-existing infections. Strongyloidiasis can become severe or fatal in immunocompromised individuals. This cross-sectional study determined the prevalence of anti-Strongyloides IgG antibody in sera collected from SARS-CoV-2 infected persons in a tertiary-care Thai hospital from January 2021 to January 2022. The survey was conducted using a rapid immunochromatographic test (ICT) kit based on a recombinant antigen of Strongyloides stercoralis known to be IgG-immunoreactive. High prevalence of anti-Strongyloides IgG antibody was found. Out of 297 SARS-CoV-2-infected patients 117 (39.4 %, 95 % CI 33.8-45.2 %) were positive for S. stercoralis according to the ICT kit. In areas where strongyloidiasis is endemic, we suggest using this point-of-care ICT kit for routine rapid screening in seriously ill COVID-19 patients who will be subjected to immunosuppressive treatment. Prompt anthelminthic treatment should be administered to prevent serious systemic strongyloidiasis in at-risk patients.
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Affiliation(s)
- Lakkhana Sadaow
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Patcharaporn Boonroumkaew
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Rutchanee Rodpai
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Oranuch Sanpool
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Prinya Prasongdee
- Genomic and Precision Laboratory Unit, Clinical Laboratory Section, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pewpan M Intapan
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wanchai Maleewong
- Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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2
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Wongphutorn P, Noordin R, Anuar NS, Worasith C, Kopolrat KY, Homwong C, Tippayawat P, Techasen A, Pitaksakurat O, Sithithaworn J, Eamudomkarn C, Sithithaworn P. Examination of Diagnostic Performance of New IgG4 Rapid Test Compared with IgG- and IgG4-ELISAs to Investigate Epidemiology of Strongyloidiasis in Northeast Thailand. Am J Trop Med Hyg 2024; 110:254-262. [PMID: 38190756 PMCID: PMC10859814 DOI: 10.4269/ajtmh.23-0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024] Open
Abstract
Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised individuals, and accurate diagnosis leading to timely treatment can save lives. Serodiagnosis is a sensitive method for diagnosis and is recommended for screening high-risk individuals. A point-of-care rapid test will facilitate the screening activities, especially in low-resource settings. This study aims to apply a new IgG4 immunochromatographic test using S. stercoralis recombinant antigen (SsRapid® cassette test) and to compare it with in-house IgG and IgG4 enzyme-linked immunosorbent assays (IgG- and IgG4-ELISAs) using native Strongyloides ratti antigen to investigate the epidemiology of strongyloidiasis in northeast Thailand. A total of 300 people participated, with 136 males and 164 females of a similar mean age. The reference tests were fecal examinations using the formalin-ethyl acetate concentration technique and an agar plate culture technique. The prevalence of S. stercoralis determined by SsRapid (81.7%) was significantly higher than that by fecal examinations (43.3%) or by antibody detection by IgG-ELISA (53.0%) or IgG4-ELISA (44.0%). The diagnostic sensitivities of SsRapid, IgG-ELISA, and IgG4-ELISA were found to be 93.9%, 77.7%, and 63.1%, respectively. The rate of positive tests by the SsRapid was significantly correlated to the levels of Strongyloides-specific IgG4 and IgG antibodies. By all diagnostic methods, male participants had a significantly higher prevalence of strongyloidiasis than females. Age was significantly associated with the concentration of specific serum IgG but not with the SsRapid grading score. In conclusion, SsRapid was shown to be a sensitive and valuable diagnostic test for the epidemiology study of strongyloidiasis.
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Affiliation(s)
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia
| | - Chanika Worasith
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y. Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Anchalee Techasen
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Opal Pitaksakurat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Boonroumkaew P, Sadaow L, Janwan P, Rodpai R, Sanpool O, Buadee P, Suprom C, Thanchomnang T, Intapan PM, Maleewong W. Improved diagnostic sensitivity of human strongyloidiasis using point-of-care mixed recombinant antigen-based immunochromatography. Parasite 2023; 30:60. [PMID: 38099622 PMCID: PMC10723528 DOI: 10.1051/parasite/2023063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023] Open
Abstract
Strongyloidiasis is a neglected tropical disease that can cause fatal complications due to hyperinfection and disseminated strongyloidiasis in immunocompromised patients. We used two Strongyloides stercoralis recombinant antigenic proteins, L3NieAg.01 (NIE) and IgG-immunoreactive antigen (SsIR), to develop the recombinant antigen-based immunochromatography test (ICT) kit. We constructed and compared kits using either the NIE (NIE ICT kit) or the SsIR (SsIR ICT kit) antigens and a kit using a mixture of both (NIE-SsIR ICT kit) for detection of anti-Strongyloides IgG antibody in human serum samples. Serum samples from normal healthy individuals (Group I, n = 40), proven strongyloidiasis patients (Group II, n = 100), and those with other parasitic infections (Group III, n = 154) were evaluated. Sensitivity and specificity were 81.0% and 84.0% for the NIE ICT kit, 89.0% and 83.5% for the SsIR ICT kit, and 95.0% and 90.2% for the NIE-SsIR ICT kit, respectively. The NIE-SsIR ICT kit provided the best diagnostic results; it can supplement stool examination for clinical diagnosis and can be used to screen for asymptomatic S. stercoralis infection in people at risk in endemic areas. The NIE-SsIR ICT kit can also be used in large-scale sero-epidemiological investigations in endemic areas without the need for additional facilities or ancillary supplies.
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Affiliation(s)
- Patcharaporn Boonroumkaew
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Lakkhana Sadaow
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Penchom Janwan
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
- Department of Medical Technology, School of Allied Health Sciences, Walailak University 80161 Nakhon Si Thammarat Thailand
- Hematology and Transfusion Science Research Center, Walailak University 80161 Nakhon Si Thammarat Thailand
| | - Rutchanee Rodpai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Oranuch Sanpool
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Punyisa Buadee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Chanida Suprom
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Tongjit Thanchomnang
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
- Faculty of Medicine, Mahasarakham University 44000 Maha Sarakham Thailand
| | - Pewpan M. Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
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Wongphutorn P, Worasith C, Kopolrat KY, Homwong C, Sithithaworn J, Eamudomkarn C, Techasen A, Tippayawat P, Pitaksakurat O, Hongsrichan N, Crellen T, Sithithaworn P. Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis. Parasit Vectors 2023; 16:298. [PMID: 37641157 PMCID: PMC10464225 DOI: 10.1186/s13071-023-05935-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Detection of parasite-specific IgG in urine is a sensitive method for diagnosis of strongyloidiasis and gives similar accuracy to serum IgG. However, there are no data concerning detection of IgG subclass in urine. To further explore the utility of diagnosis from urine samples, we evaluated the diagnostic performance of IgG4 in urine compared with parasitological and other immunological methods. METHODS The urine and sera included proven strongyloidiasis (group 1, n = 93), other parasitic infections (group 2, n = 40) and parasite negatives (group 3, n = 93). The performance of Strongyloides-specific IgG4 in urine for diagnosis of strongyloidiasis using fecal examinations as the reference standard was assessed. RESULTS With fecal examination as a gold standard, Strongyloides-specific IgG4 in urine had 91.4% sensitivity and 93.2% specificity while serum IgG4 had 93.6% sensitivity and 91.0% specificity. IgG4 in both urine and serum had almost perfect diagnostic agreements with fecal examination (Cohen's kappa coefficient was > 0.8). Cross-reactivity to Opisthorchis viverrini and Taenia spp. of IgG4 in urine were 7.5% and 12.5% in serum. Concurrent analyses of total IgG in urine and serum showed that the sensitivities (97.9-100%) and specificities (88.7-91.0%) were similar (P > 0.05). The sensitivity for parasitological examination by the formalin-ethyl acetate concentration technique (FECT) was 49.5% and that for agar plate culture technique (APC) it was 92.6%. CONCLUSION Our findings showed that specific IgG4 detection in urine yielded similar diagnostic performance to the same biomarkers in serum. This suggests that accurate diagnosis of strongyloidiasis can be performed using urine samples and IgG4 is a valid choice of diagnostic marker. Further assessment is required to assess the utility of urine IgG4 for measuring the response treatment in strongyloidiasis.
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Affiliation(s)
| | - Chanika Worasith
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anchalee Techasen
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | | | - Opal Pitaksakurat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thomas Crellen
- School of Biodiversity One Health and Veterinary Medicine, University of Glasgow, Graham Kerr Building, Glasgow, UK
- Wellcome Centre for Integrative Parasitology, University of Glasgow, Sir Graeme Davies Building, Glasgow, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Osman E, Amin NA, Noon TPM, Lahat SNH, Rosli MS, Sham SF, Periyasamy PR, Ghazali N, Manap SNAA, Noordin R. Comparison of Two Serological Assays in Detecting Strongyloides Infection in Immunocompromised Patients. Am J Trop Med Hyg 2022; 107:tpmd220076. [PMID: 35895335 PMCID: PMC9490643 DOI: 10.4269/ajtmh.22-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 11/07/2022] Open
Abstract
Strongyloides infection may develop into fatal hyperinfection and dissemination syndrome in immunocompromised hosts. Despite suboptimal specificity issues, the detection of IgG antibodies by ELISA has been central in the serodiagnosis of Strongyloides infection. Recently, an IgG4-based lateral-flow test (SsRapid) using recombinant NIE (rNIE) protein with good diagnostic performance has been reported. This study assessed the result concordance between a commercial IgG-ELISA and the SsRapid. Additionally, we determined the Strongyloides seroprevalence and its association with clinical manifestations. Immunocompromised patients (N = 200) were from Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, and were diagnosed with HIV/AIDS, hematological malignancy, and solid organ cancers. Their plasma samples were tested using a commercial IgG-ELISA and SsRapid. A fair concordance (κ = 0.27-0.33; P < 0.05) among the tests was demonstrated. The SsRapid exhibited a significantly higher (P < 0.05) seroprevalence (10.5% [21/200]) compared with IgG-ELISA (7.5% [15/200]). After adsorption with rNIE, all SsRapid-positive samples tested negative with the rapid test, thus showing binding specificity. There was no significant association with clinical manifestations. This study revealed that SsRapid is a useful diagnostic tool for Strongyloides infection, and there is a notable seroprevalence among the immunocompromised patients.
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Affiliation(s)
- Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Azma Amin
- Universiti Kuala Lumpur Institute of Medical Science Technology Selangor, Malaysia
| | - Thieeraporn Phraseart Ma Noon
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nuratiqah Hanani Lahat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad Syairazi Rosli
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shazia Farhana Sham
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Nuraffini Ghazali
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nor Azreen Abd Manap
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia (USM), Penang, Malaysia
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Tamarozzi F, Longoni SS, Mazzi C, Rizzi E, Noordin R, Buonfrate D. The accuracy of a recombinant antigen immunochromatographic test for the detection of Strongyloides stercoralis infection in migrants from sub-Saharan Africa. Parasit Vectors 2022; 15:142. [PMID: 35461265 PMCID: PMC9034504 DOI: 10.1186/s13071-022-05249-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Strongyloidiasis, a nematode infection which is mainly caused by Strongyloides stercoralis in humans, can lead to a fatal syndrome in immunocompromised individuals. Its diagnosis is challenging due to the absence of a diagnostic gold standard. The infection is highly prevalent in migrants from endemic countries in tropical and subtropical areas, and a rapid diagnostic test would be helpful for screening purposes. The aim of this study was to estimate the accuracy of a novel immunochromatographic test (ICT) for the diagnosis of S. stercoralis infection. Methods A single-centre diagnostic accuracy study was undertaken using well-characterized frozen sera available from the biobank of a referral hospital for parasitic diseases in Italy. The included sera were from migrants from sub-Saharan Africa, and matching results were available for agar plate culture and/or polymerase chain reaction for S. stercoralis; moreover, the results of both a commercial enzyme-linked immunosorbent assay test and an in-house immunofluorescence test for strongyloidiasis were made available. Laboratory staff who read the ICT results were blinded as regards the results of the other tests. Two readers independently read the ICT, and a third one was involved when results were discrepant. The accuracy of the ICT was assessed both against the results of the panel of faecal tests and by latent class analysis (LCA). Results Agreement between the readers was excellent [Cohen’s κ = 92.7%, 95% confidence interval (CI) 88.3–97.1%]. When assessed against the results of the faecal tests, the sensitivity and specificity of the ICT were 82.4% (95% CI 75.7–89.0%) and 73.8% (95% CI 66.8–80.9%), respectively. According to the LCA, the sensitivity and specificity were 86.3% (95% CI 80.1–92.5%) and 73.9% (95% CI 67.0–80.8%), respectively. Conclusions The results of the ICT demonstrated ease of interpretation. The accuracy proved good, though the sensitivity might be further improved for screening purposes. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05249-z.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Silvia Stefania Longoni
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Cristina Mazzi
- Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Eleonora Rizzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy.
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Noordin R, Osman E, Kalantari N, Anuar NS, Gorgani-Firouzjaee T, Sithithaworn P, Juri NM, Rahumatullah A. A point-of-care cassette test for detection of Strongyloides stercoralis. Acta Trop 2022; 226:106251. [PMID: 34808116 DOI: 10.1016/j.actatropica.2021.106251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/05/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
Strongyloides stercoralis is a parasite that causes strongyloidiasis worldwide. It may lead to a life-long infection in immunocompetent people and hyperinfection in immunosuppressed patients. A point-of-care (POC) rapid test is helpful for patient diagnosis in resource-limited settings and as a detection tool in elimination/control programs. Previously, we reported a rapid IgG4 dipstick test (Ss Rapid®) for Strongyloides suitable for a laboratory setting. A POC cassette format of the test, which is field-applicable, has since been developed. Here, we report on a laboratory-based evaluation of the Ss Rapid® cas sette test on 285 sera. We assessed the diagnostic sensitivity of the Ss Rapid® cas sette with 32 sera, comprising samples from larval and/or DNA positive individuals from three countries. Additionally, we also tested samples from 33 seropositive endemic areas residents. We evaluated the diagnostic specificity of the test using 220 samples, comprising sera from other infections (n = 101), allergy cases with high IgE antibodies (n = 4), and blood donors (n = 115). The test showed high diagnostic sensitivity (97%, 31/32), and all sera of the seropositive endemic residents were reactive. It also showed high diagnostic specificity (94.5%, 208/220), and all false-positive samples tested negative after sera adsorption using recombinant NIE-coated microsphere beads. Additionally, we showed that the test worked with spiked whole blood samples. The study results showed that the SsRapid® cas sette test merits further laboratory and field evaluations.
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8
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Di Nardo F, Chiarello M, Cavalera S, Baggiani C, Anfossi L. Ten Years of Lateral Flow Immunoassay Technique Applications: Trends, Challenges and Future Perspectives. SENSORS (BASEL, SWITZERLAND) 2021; 21:5185. [PMID: 34372422 PMCID: PMC8348896 DOI: 10.3390/s21155185] [Citation(s) in RCA: 165] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022]
Abstract
The Lateral Flow Immunoassay (LFIA) is by far one of the most successful analytical platforms to perform the on-site detection of target substances. LFIA can be considered as a sort of lab-in-a-hand and, together with other point-of-need tests, has represented a paradigm shift from sample-to-lab to lab-to-sample aiming to improve decision making and turnaround time. The features of LFIAs made them a very attractive tool in clinical diagnostic where they can improve patient care by enabling more prompt diagnosis and treatment decisions. The rapidity, simplicity, relative cost-effectiveness, and the possibility to be used by nonskilled personnel contributed to the wide acceptance of LFIAs. As a consequence, from the detection of molecules, organisms, and (bio)markers for clinical purposes, the LFIA application has been rapidly extended to other fields, including food and feed safety, veterinary medicine, environmental control, and many others. This review aims to provide readers with a 10-years overview of applications, outlining the trends for the main application fields and the relative compounded annual growth rates. Moreover, future perspectives and challenges are discussed.
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Affiliation(s)
- Fabio Di Nardo
- Department of Chemistry, University of Torino, 10125 Torino, Italy; (M.C.); (S.C.); (C.B.); (L.A.)
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Phupiewkham W, Sadaow L, Sanpool O, Rodpai R, Yamasaki H, Ittiprasert W, Mann VH, Brindley PJ, Maleewong W, Intapan PM. Comparative assessment of immunochromatographic test kits using somatic antigens from adult Opisthorchis viverrini and IgG and IgG4 conjugates for serodiagnosis of human opisthorchiasis. Parasitol Res 2021; 120:2839-2846. [PMID: 34259939 DOI: 10.1007/s00436-021-07224-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/14/2021] [Indexed: 12/14/2022]
Abstract
Chronic infections of humans with Opisthorchis viverrini and Clonorchis sinensis spanning decades may lead to life-threatening pathology prior to cholangiocarcinoma (CCA), which usually has a poor prognosis. Serological tools can support the parasitological examination in clinical diagnosis and support screening for risk of CCA. We developed novel immunochromatographic test kits using a soluble, somatic tissue extract of adult O. viverrini worms as an antigen and colloidal gold-labeled conjugates of IgG and IgG4 antibodies, and evaluated the diagnostic values of both the OvSO-IgG and OvSO-IgG4 kits. For diagnosis of human opisthorchiasis individually, the diagnostic sensitivity, specificity, and positive and negative predictive values with 95% confidence intervals in the OvSO-IgG kit were 86.6% (78.9-92.3), 89.5% (84.2-93.5), 82.9% (74.8-89.2), and 91.9% (87.0-95.4), respectively, while the 75% (65.9-82.7), 98.4% (95.5-99.7), 96.6% (90.3-99.3), and 87% (81.7-91.2), respectively, for the OvSO-IgG4 kit at the prevalence of infection of 37.1%. Twenty-three (76.7%) and 14 (46.7%) of 30 clonorchiasis sera showed positive reactivity with the OvSO-IgG and OvSO-IgG4 kits, respectively. There was 84.1% (κ-value = 0.649) concordance between the two kits, which was statistically significant (p < 0.001). Both ICT kits can be employed as quick and easy point-of-care diagnostic tools, and hence, the OvSO-IgG and OvSO-IgG4 kits can support expanded capacity for clinical diagnosis of human opisthorchiasis and clonorchiasis. These kits may find utility in large-scale surveys in endemic areas where there are limited sophisticated medical facilities or capacity.
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Affiliation(s)
- Weeraya Phupiewkham
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Science and Mathematics, Faculty of Science and Technology, Rajamangala University of Technology Tawan-Ok, Chonburi, 20110, Thailand
| | - Lakkhana Sadaow
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Oranuch Sanpool
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Rutchanee Rodpai
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Hiroshi Yamasaki
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
| | - Wannaporn Ittiprasert
- Department of Microbiology, Immunology and Tropical Medicine, Research Center for Neglected Diseases of Poverty, School of Medicine and Health Science, George Washington University, Washington, DC, 20052, USA
| | - Victoria H Mann
- Department of Microbiology, Immunology and Tropical Medicine, Research Center for Neglected Diseases of Poverty, School of Medicine and Health Science, George Washington University, Washington, DC, 20052, USA
| | - Paul J Brindley
- Department of Microbiology, Immunology and Tropical Medicine, Research Center for Neglected Diseases of Poverty, School of Medicine and Health Science, George Washington University, Washington, DC, 20052, USA.
| | - Wanchai Maleewong
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Pewpan M Intapan
- Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand.
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