Diagnosis of human enterovirus A71 infection in Malaysia using a commercial IgM-capture enzyme-linked immunosorbent assay and an IgM-colloidal gold immunochromatographic assay
- Author:
Aw-Yong, K.L., Tan, C.W., Sam, I.C. and Chan, Y.F.
- Publication Type:Journal Article
- From:Tropical Biomedicine
2016;33(2):238-245
- CountryMalaysia
- Language:English
-
Abstract:
Hand, foot and mouth disease (HFMD) is a common childhood infection caused by
many enteroviruses, including enterovirus A71 (EV-A71). As EV-A71 is associated with severe
neurological disease, early diagnosis is critical for clinical and public health management. In
developing countries such as Malaysia, laboratory capacity to carry out EV-A71 IgM detection
is greater than that of the gold standard methods of virus culture or molecular detection. This
study evaluated two diagnostic kits, EV-A71 IgM-capture enzyme-linked immunosorbent
(ELISA) and EV-A71 IgM-colloidal gold immunochromatographic assay (GICA), which had
previously only been assessed in China. The assays were tested with 89 serum samples from
patients with suspected HFMD. The sensitivity, specificity, positive predictive value, and
negative predictive value rates were 78.4%, 80.8%, 74.4%, and 84.0%, respectively, for the
IgM-capture ELISA, and 75.7%, 76.9%, 70.0%, and 81.6% for the IgM GICA. These performance
measures were similar between the two assays. Concordance between the two assays was
91.1%. The sensitivity rates were lower than those previously reported, likely because the
multiple circulating EV-A71 genotypes in Malaysia differ from the C4 subgenotype found in
China and used in the assays. Both assays had low false positive rates (12.5% and 16.7% for
ELISA and GICA, respectively) when tested on sera from patients confirmed to have
enteroviruses. Both diagnostic kits are suitable for early diagnosis of HFMD caused by EV-
A71 in Malaysia, but confirmation with culture or PCR is still important.
- Full text:P020160830522439419218.pdf
