Abstract
ROLE OF MICROSCOPIC AGGLUTINATION TEST (MAT) FOR THE DIAGNOSIS OF LATE /COMPLICATED LEPTOSPIROSIS

Dr. Pamireddy Madhavi Latha*, Dr. Krishna Kanchan Sharma, Dr. Alladi Mohan, Dr. Usha Kalawat and Dr. P. V. G. K. Sarma

ABSTRACT

Leptospirosis is an endemic spirochaetal zoonosis of worldwide distribution and is underreported due to protean manifestations. It is often mistaken for locally prevalent infectious and non-infectious diseases. It is associated with high morbidity and mortality. Specific diagnostic tools for the disease include blood cultures for leptospires, serologic methods such as microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA), as well as molecular methods, polymerase chain reaction (PCR). Serology remains the mainstay for the diagnosis of leptospirosis as the gold standard MAT is difficult to perform and requires maintenance of live antigens while others are expensive. Aim: This study was taken up to know the efficiency of IgM ELISA for the diagnosis of leptospirosis in comparison with MAT at tertiary care centre. Settings and Design: The study was carried out from July 2010 to January 2011, during which 151 blood samples were received from suspected cases of leptospirosis. IgM ELISA for leptospirosis was performed with Serion Virion IgM ELISA Kit. MAT was performed using live cultures of leptospira grown on liquid EMJH medium using a battery of 12 antigens as per standard protocol. Statistical analysis used: The sensitivity, specificity, positive predictive value and negative predictive value of IgM assay was calculated. Results: The sensitivity, specificity, positive predictive value and negative predictive value of IgM assay was calculated using 2x2 tables and found to be 44.44%, 57.37%, 72.13%, 38.88% respectively using MAT as the Gold standard. Conclusions: In the present study, MAT was positive in 99 cases (78.65 %) and IgM ELISA in 61 cases (40.4%). The predominant serovar was L. australis.

Keywords: MAT, Microscopic Agglutination Test. IgM ELISA, Enzyme Linked Immunosorbent Assay, PCR, Polymerase Chain Reaction, Leptospirosis.


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