Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study

<p>Abstract</p> <p>Background</p> <p>Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglu...

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Main Authors: Liyanapathirana Veranja C, Agampodi Suneth B, Wimalaratna Harith, Dassanayake Dinesh LB, Piyarathna Thibbotumunuwe ACL, Goonapienuwala Bimba L
Format: Article
Language:English
Published: BMC 2009-04-01
Series:BMC Infectious Diseases
Online Access:http://www.biomedcentral.com/1471-2334/9/48
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author Liyanapathirana Veranja C
Agampodi Suneth B
Wimalaratna Harith
Dassanayake Dinesh LB
Piyarathna Thibbotumunuwe ACL
Goonapienuwala Bimba L
author_facet Liyanapathirana Veranja C
Agampodi Suneth B
Wimalaratna Harith
Dassanayake Dinesh LB
Piyarathna Thibbotumunuwe ACL
Goonapienuwala Bimba L
author_sort Liyanapathirana Veranja C
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT).</p> <p>Methods</p> <p>The study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1<sup>st </sup>July 2007 to 31<sup>st </sup>July 2008. The subjects were screened to diagnose leptospirosis according to the leptospirosis case definition. MAT was performed on blood samples taken from each patient on the 7<sup>th </sup>day of fever. Leptospirosis case definition was evaluated in regard to sensitivity, specificity and predictive values, using a MAT titre ≥ 1:800 for confirming leptospirosis.</p> <p>Results</p> <p>A total of 123 patients were initially recruited of which 73 had clinical features compatible with the surveillance case definition. Out of the 73 only 57 had a positive MAT result (true positives) leaving 16 as false positives. Out of the 50 who didn't have clinical features compatible with the case definition 45 had a negative MAT as well (true negatives), therefore 5 were false negatives. Total number of MAT positives was 62 out of 123. According to these results the test sensitivity was 91.94%, specificity 73.77%, positive predictive value and negative predictive values were 78.08% and 90% respectively. Diagnostic accuracy of the test was 82.93%.</p> <p>Conclusion</p> <p>This study confirms that the surveillance case definition has a very high sensitivity and negative predictive value with an average specificity in diagnosing leptospirosis, based on a MAT titre of ≥ 1: 800.</p>
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spelling doaj.art-c69f972e1c254f78ba6c52a41257bfe22022-12-22T00:09:40ZengBMCBMC Infectious Diseases1471-23342009-04-01914810.1186/1471-2334-9-48Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation studyLiyanapathirana Veranja CAgampodi Suneth BWimalaratna HarithDassanayake Dinesh LBPiyarathna Thibbotumunuwe ACLGoonapienuwala Bimba L<p>Abstract</p> <p>Background</p> <p>Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT).</p> <p>Methods</p> <p>The study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1<sup>st </sup>July 2007 to 31<sup>st </sup>July 2008. The subjects were screened to diagnose leptospirosis according to the leptospirosis case definition. MAT was performed on blood samples taken from each patient on the 7<sup>th </sup>day of fever. Leptospirosis case definition was evaluated in regard to sensitivity, specificity and predictive values, using a MAT titre ≥ 1:800 for confirming leptospirosis.</p> <p>Results</p> <p>A total of 123 patients were initially recruited of which 73 had clinical features compatible with the surveillance case definition. Out of the 73 only 57 had a positive MAT result (true positives) leaving 16 as false positives. Out of the 50 who didn't have clinical features compatible with the case definition 45 had a negative MAT as well (true negatives), therefore 5 were false negatives. Total number of MAT positives was 62 out of 123. According to these results the test sensitivity was 91.94%, specificity 73.77%, positive predictive value and negative predictive values were 78.08% and 90% respectively. Diagnostic accuracy of the test was 82.93%.</p> <p>Conclusion</p> <p>This study confirms that the surveillance case definition has a very high sensitivity and negative predictive value with an average specificity in diagnosing leptospirosis, based on a MAT titre of ≥ 1: 800.</p>http://www.biomedcentral.com/1471-2334/9/48
spellingShingle Liyanapathirana Veranja C
Agampodi Suneth B
Wimalaratna Harith
Dassanayake Dinesh LB
Piyarathna Thibbotumunuwe ACL
Goonapienuwala Bimba L
Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
BMC Infectious Diseases
title Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
title_full Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
title_fullStr Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
title_full_unstemmed Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
title_short Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study
title_sort evaluation of surveillance case definition in the diagnosis of leptospirosis using the microscopic agglutination test a validation study
url http://www.biomedcentral.com/1471-2334/9/48
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