Evaluation Of Diagnostic Utility Of Modified Faine’s Criteria In Leptospirosis- Experience From A Tertiary Care Hospital.
Evaluation Of Diagnostic Utility Of Modified Faine’s Criteria In Leptospirosis
DOI:
https://doi.org/10.70284/njirm.v6i4.932Keywords:
Leptospirosis; modidified Faine’s criteria; MATAbstract
Background & Objective: Leptospirosis is an emerging infectious disease, for the diagnosis of which clinical, epidemiological and laboratory parameters may be evaluated as per modidified Faine’s criteria suggested by several authors. The objective of this study was to validate the utility of modified Faine’s criteria in the diagnosis of leptospirosis. Methodology: This study was carried out at a tertiary care hospital in Bengaluru, India from January 2011 to April 2012. Blood, urine and paired sera from one hundred patients with clinical suspicion of leptospirosis were collected. Relevant clinical and epidemiological details of these patients were also obtained as per modified Faine’s criteria. Blood and urine samples of these patients were subjected to Dark Field Microscopy (DFM) and culture, whereas, their sera were subjected to Immuno chromatography (IgM Leptocheck), IgM Enzyme Linked Immuno Sorbent Assay (IgM ELISA) and Macroscopic Slide Agglutination Test (MSAT). All the leptospira seropositive samples were subjected to Microscopic Agglutination Test (MAT) which was also used as the gold standard to validate all the aforementioned serological tests and modified Faine’s criteria. Results: Positive Predictive Values (PPV) of all the aforementioned serological screening tests and modified Faine’s criteria were calculated. PPV of IgM Leptocheck, MSAT, IgM ELISA and modified Faine’s criteria were found to be 14.3%, 6.5%, 8.7% and 21% respectively. Conclusion: The diagnosis of leptospirosis (both laboratory & clinical) is an uphill task. A high index of suspicion is needed in endemic areas & leptospirosis must be considered when a patient presents with acute onset of fever, headache & myalgia. From the results obtained in our study, it seems that modified Faine’s criteria may not be as useful a diagnostic tool as it has traditionally been thought to be. More studies should be carried out to evaluate its diagnostic utility.[Bhatia M NJIRM 2015; 6(4):20-26]
References
2. Levett PN. Leptospirosis.Clin Microbiol Rev 2001 April;14(2):296-326
3. Singh SS. Clinical Manifestations. In:Leptospirosis Laboratory Manual. Regional Medical Research centre, Port Blair,WHO Country office for India:WHO;2007. p.22-26
4. Faine.S. Guidelines for the control of Leptospirosis. WHO offset publication 1982:67
5. Brato DG, Mendoza MT, Coredero CP, Leptospirosis Study Group. Validation of the WHO criteria using the MAT as the gold standard in the diagnosis of leptospirosis. PJMID 1998;27:125-128.
6. Shivakumar S, Shareek PS. Diagnosis of leptospirosis utilizing modified Faine’s criteria. JAPI 2004 Aug;52:678-79
7. Sehgal SC. Leptospirosis on the Horizon. The National Medical Journal of India 2000;13(5):228-30
8. Betty AF, Daniel FS, Alice SW, editors. The Spirochetes. In: Bailey &Scott's.Diagnostic Microbiology. 12th ed. St.Louis, Missouri: Pub : Mosby Elsevier; 2007. p.539-40
9. Sharma KK, Kalawat U. Early diagnosis of leptospirosis by conventional methods: One year prospective study. Indian J Pathol Microbiol 2008; 5:209-11
10. Carlos RRC, Eduardo PB. Pulmonary complications of leptospirosis.Clin Chest Med 2002;23:469-78
11. Mary DB, David AA, Sandra LB, Christopher WW, Tin A, Richard AS et al. Evaluation of Four Commercially Available Rapid Serological Tests for Diagnosis of Leptospirosis. J Clin Microbiol 2003 Feb;41(2):803-09
12. Pimjai N, Piyada W, Wimol P, Ornnalin L, Paijit W. A Comparitive Evaluation of Different Methods for the Serological Diagnosis of Leptospirosis. J Trop Med Parasitol 2000 December;23(2):59-65
13. World Health Organization. Human Leptospirosis: Guidance for diagnosis, surveillance and control [Book on the internet].World Health Organization;2003 http://whqlibdoc.who.int./hq/2003/2003/WHO_CDS_CSR_EPH_2002.23.pdf14. Brandao AP, Camargo ED, Silva ED, Silva MV, Abrao RV. Macroscopic Agglutination Test for rapid diagnosis of human Leptospirosis. J Clin Microbiol 1998 Nov;36(11):3138-42
15. Hamid RH, Gholamreza A, Seyyed SE. Comparison of two ELISA methods for the laboratory diagnosis of acute leptospirosis. Iran J Med Sci 2010; 35(2):116-21
16. Sekhar WY, Soo EH, Gopalakrishnan V, Devi S. Leptospirosis in Kuala Lumpur and the comparitive evaluation of two rapid commercial diagnostic kits against the MAT test for the detection of antibodies to Leptospirainterrogans. Singapore Med J 2000; 41(8): 370-75
17. Tanvi P, Summaiya M, Parul P. Seroprevalance of leptospirosis in south Gujarat region by evaluating the two rapid commercial diagnostic kits against the MAT test for detection of antibodies to Leptospira interrogans. National Journal of Community Medicine 2011; 2(1):64-70
18. Carniero I, Howard N, editors. Prevention Strategies. In: Introduction to epidemiology. 2nd ed. Maidenhead, Berkshire: Pub: Open University Press; 2011.p.137-54
