Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| Outros Autores: | , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| DOI: | 10.1371/journal.pntd.0006285 |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/25872 |
Resumo: | The National Institutes of Health [grant numbers R44 AI072856, U01 AI088752, R01 AI052473, D43 TW00919, R44 A1072856], the Duke Global Health Institute, and the Brazilian National Council for Scientific and Technological Development (CNPq). |
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Nabity, Scott AHagan, José EAraújo, Guilherme CDamião, Alcinéia OliveiraCruz, Jaqueline SilvaNery Junior, Nivison Ruy RochaWunder Junior, Elsio AugustoReis, Mitermayer Galvão dosKo, Albert IcksangRibeiro, Guilherme de Sousa2018-04-16T18:41:00Z2018-04-16T18:41:00Z2018NABITY, S. A. et al. Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients. PLoS Neglected Tropical Diseases, v. 12, n. 2, e0006285, 2018.1935-2727https://www.arca.fiocruz.br/handle/icict/2587210.1371/journal.pntd.0006285The National Institutes of Health [grant numbers R44 AI072856, U01 AI088752, R01 AI052473, D43 TW00919, R44 A1072856], the Duke Global Health Institute, and the Brazilian National Council for Scientific and Technological Development (CNPq).Harvard Medical School. Massachusetts General Hospital. Departments of Medicine and Pediatrics. Boston, United States of America / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, United States of AmericaFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilYale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, United States of AmericaFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, United States of AmericaFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Departamento de Saúde Coletiva. Salvador, BA, BrasilEarly detection of leptospirosis with field-ready diagnostics may improve clinical management and mitigate outbreaks. We previously validated the point-of-care Dual Path Platform (DPP) for leptospirosis with sera in the laboratory. This prospective study compares the diagnostic accuracy and clinical utility of the DPP using finger stick blood (FSB) against the serum DPP, venous whole blood (VWB) DPP, IgM-ELISA, and clinical impression. We sequentially enrolled 98 patients hospitalized for acute febrile illnesses, of which we confirmed 32 by leptospirosis reference tests. Among syndromes consistent with classic leptospirosis, the FSB DPP showed similar sensitivity and specificity (Se 93% and Sp 80%), and positive and negative predictive values (PPV 74% and NPV 95%), to VWB DPP (Se 96%, Sp 75%, PPV 68%, and NPV 97%), serum DPP (Se 85%, Sp 87%, PPV 79%, and NPV 91%) and IgM-ELISA (Se 81%, Sp 100%, PPV 100%, and NPV 90%). The FSB DPP provided a favorable likelihood ratio profile (positive LR 4.73, negative LR 0.09) in comparison to other assays and clinical impression alone. Additionally, we identified four of five leptospirosis-associated meningitis patients by whole blood DPP, none of which clinicians suspected. This demonstrates potential for the DPP in routine detection of this less common syndrome. The FSB DPP demonstrated similar discrimination for severe human leptospirosis compared with serum assays, and it is a simpler option for diagnosing leptospirosis. Its performance in other epidemiological settings and geographic regions, and for detecting atypical presentations, demands further evaluation.engPublic Library of ScienceLeptospiroseMeningiteAcuracia dos dadosDiagnósticoHumanosTratamentoLeptospirosisMeningitisAccuracy of the dataDiagnosticHumansTreatmentProspective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/25872/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALNabity S Prospective evaluation of accuracy and clinical ....pdfNabity S Prospective evaluation of accuracy and clinical 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| dc.title.pt_BR.fl_str_mv |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| title |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| spellingShingle |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients Nabity, Scott A Leptospirose Meningite Acuracia dos dados Diagnóstico Humanos Tratamento Leptospirosis Meningitis Accuracy of the data Diagnostic Humans Treatment |
| title_short |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| title_full |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| title_fullStr |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| title_full_unstemmed |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| title_sort |
Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients |
| author |
Nabity, Scott A |
| author_facet |
Nabity, Scott A Hagan, José E Araújo, Guilherme C Damião, Alcinéia Oliveira Cruz, Jaqueline Silva Nery Junior, Nivison Ruy Rocha Wunder Junior, Elsio Augusto Reis, Mitermayer Galvão dos Ko, Albert Icksang Ribeiro, Guilherme de Sousa |
| author_role |
author |
| author2 |
Hagan, José E Araújo, Guilherme C Damião, Alcinéia Oliveira Cruz, Jaqueline Silva Nery Junior, Nivison Ruy Rocha Wunder Junior, Elsio Augusto Reis, Mitermayer Galvão dos Ko, Albert Icksang Ribeiro, Guilherme de Sousa |
| author2_role |
author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Nabity, Scott A Hagan, José E Araújo, Guilherme C Damião, Alcinéia Oliveira Cruz, Jaqueline Silva Nery Junior, Nivison Ruy Rocha Wunder Junior, Elsio Augusto Reis, Mitermayer Galvão dos Ko, Albert Icksang Ribeiro, Guilherme de Sousa |
| dc.subject.other.pt_BR.fl_str_mv |
Leptospirose Meningite Acuracia dos dados Diagnóstico Humanos Tratamento |
| topic |
Leptospirose Meningite Acuracia dos dados Diagnóstico Humanos Tratamento Leptospirosis Meningitis Accuracy of the data Diagnostic Humans Treatment |
| dc.subject.en.pt_BR.fl_str_mv |
Leptospirosis Meningitis Accuracy of the data Diagnostic Humans Treatment |
| description |
The National Institutes of Health [grant numbers R44 AI072856, U01 AI088752, R01 AI052473, D43 TW00919, R44 A1072856], the Duke Global Health Institute, and the Brazilian National Council for Scientific and Technological Development (CNPq). |
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2018 |
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2018-04-16T18:41:00Z |
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2018-04-16T18:41:00Z |
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2018 |
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info:eu-repo/semantics/article |
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NABITY, S. A. et al. Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients. PLoS Neglected Tropical Diseases, v. 12, n. 2, e0006285, 2018. |
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https://www.arca.fiocruz.br/handle/icict/25872 |
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1935-2727 |
| dc.identifier.doi.none.fl_str_mv |
10.1371/journal.pntd.0006285 |
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NABITY, S. A. et al. Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients. PLoS Neglected Tropical Diseases, v. 12, n. 2, e0006285, 2018. 1935-2727 10.1371/journal.pntd.0006285 |
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