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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(01): 082-086
DOI: 10.4103/JLP.JLP_148_18
Original Article

Evaluation of loop-mediated isothermal amplification assay for detection of scrub typhus in patients with acute febrile illness presenting to a Tertiary Care Center in Puducherry, India

Patricia Anitha Karthikeyan
Vector Control Research Centre, Puducherry, India
,
Sugeerappa Laxmanappa Hoti
Regional Medical Research Centre, Belagavi, Karnataka, India
,
Reba Kanungo
Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India
› Author Affiliations Financial support and sponsorship: This study was funded by the Indian Council of Medical Research as part of intramural research funding for Vector Control Research Centre (Puducherry) Grant Sanction Number: IM 1204.
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Abstract

PURPOSE: Scrub typhus an acute febrile illness has diverse clinical manifestations, which overlap with other febrile illnesses. Due to this reason, it is misdiagnosed, leading to inappropriate treatment, sometimes resulting in fatality. Thus, accurate diagnosis of scrub typhus is important for appropriate treatment. This study evaluated the loop-mediated isothermal amplification (LAMP) assay as a diagnostic test for scrub typhus among patients with fever.

MATERIALS AND METHODS: A total of 50 cases of acute febrile illness clinically resembling scrub typhus, with or without an eschar, or cases of pyrexia of unknown origin were included in the study. Blood samples collected from these cases were subjected to detection of IgM antibodies to Orientia tsutsugamushi by ELISA, conventional groEL polymerase chain reaction (PCR), and the LAMP assay.

RESULTS: Twelve cases had fever for less than a week, and two had fever for more than 3 weeks. IgM antibodies to O. tsutsugamushi were detected in 37 out of 50 samples (74%). LAMP assay was positive in 33 samples (66%). groEL gene-based PCR detected 35 (70%) samples as positive. Two samples negative by LAMP assay were positive by this PCR. Twenty samples collected from patients with dengue, typhoid, and malaria tested by the LAMP assay were negative, indicating its good specificity. LAMP assay and the conventional groEL-based PCR could detect 72.7% and 74.3% of the samples, respectively before the 10th day after onset of fever, whereas IgM ELISA could detect only 40.5% of the 37 samples.

CONCLUSION: This study suggests that LAMP assay could be a useful diagnostic test for detecting scrub typhus in the acute phase of the illness and a cheaper alternative to other molecular methods in resource poor settings.

Key words

Diagnosis - groEl polymerase chain reaction - loop-mediated isothermal amplification assay - scrub typhus


Publication History

Received: 30 November 2108

Accepted: 22 January 2019

Article published online:
06 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
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