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ORIGINAL ARTICLE
Year : 2012  |  Volume : 53  |  Issue : 4  |  Page : 196-199

The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection


1 The Research Unit, Lassa Fever Research and Diagnostic Centre, Irrua Specialist Teaching Hospital, Irrua; Department of Ear, Nose, and Throat, College of Health Sciences, University of Abuja, Nigeria
2 Medical Biochemistry, University of Abuja, Nigeria
3 The Research Unit, Lassa Fever Research and Diagnostic Centre, Irrua Specialist Teaching Hospital; Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
4 The Research Unit, Lassa Fever Research and Diagnostic Centre, Irrua Specialist Teaching Hospital, Irrua, Nigeria

Correspondence Address:
Titus S Ibekwe
Department of ENT Surgery, College of Health Sciences, University of Abuja, PMB 117, Garki, Abuja
Nigeria
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DOI: 10.4103/0300-1652.107552

PMID: 23661877

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Background: Early diagnosis, prompt treatment, and disease containment are vital measures in the management of Lassa fever (LF), a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, the gold standard for diagnosis, is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF. Patients and Methods: A prospective case-control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM. Results: Of the 37 confirmed cases of LF infection by RT-PCR, 21 (57%) were IgM positive. Amongst the 35 confirmed negative cases (control group), eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57% and 77% respectively. The negative and positive predictive values of the IgM serological assay were 63% and 72%, respectively, while the efficiency of the test was 67%. Conclusion: The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and, hence, the need for a reliable LF "rapid screening kit" since RT-PCR is unavailable in most centers. In the interim, "high clinical index of suspicion," irrespective of IgM status, requires urgent referral to confirmatory centers.


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