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Comparison of two rapid tests for anti-phenolic glycolipid-I serology in Brazil and Nepal.

Abstract

The diagnosis of leprosy continues to be based on clinical symptoms and early diagnosis and treatment are critical to preventing disability and transmission. Sensitive and specific laboratory tests are not available for diagnosing leprosy. Despite the limited applicability of anti-phenolic glycolipid-I (PGL-I) serology for diagnosis, it has been suggested as an additional tool to classify leprosy patients (LPs) for treatment purposes. Two formats of rapid tests to detect anti-PGL-I antibodies [ML immunochromatography assay (ICA) and ML Flow] were compared in different groups, multibacillary patients, paucibacillary patients, household contacts and healthy controls in Brazil and Nepal. High ML Flow intra-test concordance was observed and low to moderate agreement between the results of ML ICA and ML Flow tests on the serum of LPs was observed. LPs were "seroclassified" according to the results of these tests and the seroclassification was compared to other currently used classification systems: the World Health Organization operational classification, the bacilloscopic index and the Ridley-Jopling classification. When analysing the usefulness of these tests in the operational classification of PB and MB leprosy for treatment and follow-up purposes, the ML Flow test was the best point-of-care test for subjects in Nepal and despite the need for sample dilution, the ML ICA test yielded better performance among Brazilian subjects. Our results identified possible ways to improve the performance of both tests.

More information

Type
Journal Article
Author
Stefani MMA
Grassi AB
Sampaio LH
Sousa ALOM
Costa MB
Scheelbeek P
Neupane KD
Hagge DA
Macdonald M
Cho S
Oskam L
Bührer-Sékula S
Year of Publication
2012
Journal
Memorias do Instituto Oswaldo Cruz
Volume
107 Suppl 1
Number of Pages
124-31
Date Published
2012 Dec
Language
eng
ISSN Number
1678-8060
Call Number
STEFANI 2012
DOI
10.1590/s0074-02762012000900019
Alternate Journal
Mem. Inst. Oswaldo Cruz
Publication Language
eng