Evaluation of lateral flow devices for rabies diagnosis in decomposed animal brain samples.

IF 3.6 Q1 TROPICAL MEDICINE
Ryota Todoroki, Joely T Ongtangco, Kazunori Kimitsuki, Nobuo Saito, Milagros R Mananggit, Cornelio R Velasco, Jaira D Mauhay, Alyssa M Garcia, Catalino S Demetria, Yamada Kentaro, Akira Nishizono
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Abstract

Background: The Direct Fluorescent Antibody Test (DFAT), the standard rabies confirmatory test, is less sensitive when used with decomposed brain samples, a frequent issue in rabies-endemic regions. This study evaluates the diagnostic accuracy of the ADTEC lateral flow device (LFD) for rabies post-mortem diagnosis using decomposed brain samples.

Methods: We used 34 animal heads submitted with a cold chain to an animal diagnostic laboratory located in central Philippines including 26 DFAT-positive and eight DFAT-negative samples. After defrosting the heads, the entire brain was extracted and left at room temperature to induce decomposition. The decomposition status was scored after 1 day, 3 days, and 4 days at room temperature. DFAT and LFD were performed using the brain samples at each timepoint to evaluate the diagnostic accuracy. The day of animal head submission to the laboratory was defined as day 0, and the DFAT results were used as the reference. Image analysis was performed to measure the intensity of the LFD-positive bands.

Results: The decomposition scores dropped by day 3 and day 4, with all samples exhibiting signs of advanced decomposition. The sensitivity of DFAT was 96.2% (95% confidence interval 80.4-99.9) on day 1, but dropped to 61.5% (P < 0.01) by day 3 and further decreased to 38.5% (20.2-59.4) by day 4. In contrast, the sensitivities and specificities of LFD on day 1, day 3, and day 4 were consistently 100% (86.3-100) and 100% (63.1-100), respectively. Visual examination of the test band intensity on the LFD suggested that the intensity of the positive bands increased as decomposition progressed.

Conclusions: ADTEC LFDs demonstrated consistently high sensitivity and specificity with decomposed brain samples observed up to day 4, making them a reliable screening tool for rabies post-mortem diagnosis in decomposed brain samples, particularly in resource-limited settings. Furthermore, LFD positive bands became more distinct as decomposition advanced.

评估用于分解动物脑样本狂犬病诊断的侧流装置。
背景:标准的狂犬病确诊试验——直接荧光抗体试验(DFAT)在处理狂犬病流行地区常见的腐烂脑样本时灵敏度较低。本研究评估了ADTEC侧流装置(LFD)在狂犬病死后诊断中的准确性。方法:我们使用了通过冷链提交到菲律宾中部动物诊断实验室的34个动物头,包括26个dfat阳性和8个dfat阴性样本。在对头部进行解冻后,提取整个大脑并将其置于室温下进行分解。分别在室温下放置1天、3天和4天后进行分解状态评分。在每个时间点使用脑样本进行DFAT和LFD以评估诊断准确性。将动物头送交实验室的日期定为第0天,以DFAT结果作为参考。进行图像分析以测量lfd阳性波段的强度。结果:分解分数在第3天和第4天下降,所有样本都表现出高级分解的迹象。DFAT在第1天的灵敏度为96.2%(95%可信区间为80.4-99.9),但下降到61.5% (P)。结论:ADTEC LFDs在第4天的腐烂脑样本中表现出持续的高灵敏度和特异性,使其成为腐烂脑样本尸检狂犬病诊断的可靠筛查工具,特别是在资源有限的环境中。随着分解的深入,LFD正带越来越明显。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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