Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos

BACKGROUND: C-Reactive Protein (CRP) has been shown to be an accurate biomarker for discriminating bacterial from viral infections in febrile patients in Southeast Asia. Here we investigate the accuracy of existing rapid qualitative and semi-quantitative tests as compared with a quantitative referen...

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Autores principales: Phommasone, Koukeo, Althaus, Thomas, Souvanthong, Phonesavanh, Phakhounthong, Khansoudaphone, Soyvienvong, Laxoy, Malapheth, Phatthaphone, Mayxay, Mayfong, Pavlicek, Rebecca L., Paris, Daniel H., Dance, David, Newton, Paul, Lubell, Yoel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743113/
https://www.ncbi.nlm.nih.gov/pubmed/26846919
http://dx.doi.org/10.1186/s12879-016-1360-2
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author Phommasone, Koukeo
Althaus, Thomas
Souvanthong, Phonesavanh
Phakhounthong, Khansoudaphone
Soyvienvong, Laxoy
Malapheth, Phatthaphone
Mayxay, Mayfong
Pavlicek, Rebecca L.
Paris, Daniel H.
Dance, David
Newton, Paul
Lubell, Yoel
author_facet Phommasone, Koukeo
Althaus, Thomas
Souvanthong, Phonesavanh
Phakhounthong, Khansoudaphone
Soyvienvong, Laxoy
Malapheth, Phatthaphone
Mayxay, Mayfong
Pavlicek, Rebecca L.
Paris, Daniel H.
Dance, David
Newton, Paul
Lubell, Yoel
author_sort Phommasone, Koukeo
collection PubMed
description BACKGROUND: C-Reactive Protein (CRP) has been shown to be an accurate biomarker for discriminating bacterial from viral infections in febrile patients in Southeast Asia. Here we investigate the accuracy of existing rapid qualitative and semi-quantitative tests as compared with a quantitative reference test to assess their potential for use in remote tropical settings. METHODS: Blood samples were obtained from consecutive patients recruited to a prospective fever study at three sites in rural Laos. At each site, one of three rapid qualitative or semi-quantitative tests was performed, as well as a corresponding quantitative NycoCard Reader II as a reference test. We estimate the sensitivity and specificity of the three tests against a threshold of 10 mg/L and kappa values for the agreement of the two semi-quantitative tests with the results of the reference test. RESULTS: All three tests showed high sensitivity, specificity and kappa values as compared with the NycoCard Reader II. With a threshold of 10 mg/L the sensitivity of the tests ranged from 87–98 % and the specificity from 91–98 %. The weighted kappa values for the semi-quantitative tests were 0.7 and 0.8. CONCLUSION: The use of CRP rapid tests could offer an inexpensive and effective approach to improve the targeting of antibiotics in remote settings where health facilities are basic and laboratories are absent. This study demonstrates that accurate CRP rapid tests are commercially available; evaluations of their clinical impact and cost-effectiveness at point of care is warranted.
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spelling pubmed-47431132016-02-06 Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos Phommasone, Koukeo Althaus, Thomas Souvanthong, Phonesavanh Phakhounthong, Khansoudaphone Soyvienvong, Laxoy Malapheth, Phatthaphone Mayxay, Mayfong Pavlicek, Rebecca L. Paris, Daniel H. Dance, David Newton, Paul Lubell, Yoel BMC Infect Dis Technical Advance BACKGROUND: C-Reactive Protein (CRP) has been shown to be an accurate biomarker for discriminating bacterial from viral infections in febrile patients in Southeast Asia. Here we investigate the accuracy of existing rapid qualitative and semi-quantitative tests as compared with a quantitative reference test to assess their potential for use in remote tropical settings. METHODS: Blood samples were obtained from consecutive patients recruited to a prospective fever study at three sites in rural Laos. At each site, one of three rapid qualitative or semi-quantitative tests was performed, as well as a corresponding quantitative NycoCard Reader II as a reference test. We estimate the sensitivity and specificity of the three tests against a threshold of 10 mg/L and kappa values for the agreement of the two semi-quantitative tests with the results of the reference test. RESULTS: All three tests showed high sensitivity, specificity and kappa values as compared with the NycoCard Reader II. With a threshold of 10 mg/L the sensitivity of the tests ranged from 87–98 % and the specificity from 91–98 %. The weighted kappa values for the semi-quantitative tests were 0.7 and 0.8. CONCLUSION: The use of CRP rapid tests could offer an inexpensive and effective approach to improve the targeting of antibiotics in remote settings where health facilities are basic and laboratories are absent. This study demonstrates that accurate CRP rapid tests are commercially available; evaluations of their clinical impact and cost-effectiveness at point of care is warranted. BioMed Central 2016-02-04 /pmc/articles/PMC4743113/ /pubmed/26846919 http://dx.doi.org/10.1186/s12879-016-1360-2 Text en © Phommasone et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Technical Advance
Phommasone, Koukeo
Althaus, Thomas
Souvanthong, Phonesavanh
Phakhounthong, Khansoudaphone
Soyvienvong, Laxoy
Malapheth, Phatthaphone
Mayxay, Mayfong
Pavlicek, Rebecca L.
Paris, Daniel H.
Dance, David
Newton, Paul
Lubell, Yoel
Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title_full Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title_fullStr Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title_full_unstemmed Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title_short Accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural Laos
title_sort accuracy of commercially available c-reactive protein rapid tests in the context of undifferentiated fevers in rural laos
topic Technical Advance
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743113/
https://www.ncbi.nlm.nih.gov/pubmed/26846919
http://dx.doi.org/10.1186/s12879-016-1360-2
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