Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients

dc.creatorNabity, Scott A
dc.creatorHagan, José E
dc.creatorAraújo, Guilherme C
dc.creatorDamião, Alcinéia Oliveira
dc.creatorCruz, Jaqueline Silva
dc.creatorNery Junior, Nivison Ruy Rocha
dc.creatorWunder Junior, Elsio Augusto
dc.creatorReis, Mitermayer Galvão dos
dc.creatorKo, Albert Icksang
dc.creatorRibeiro, Guilherme de Sousa
dc.date2018-04-16T18:41:00Z
dc.date2018-04-16T18:41:00Z
dc.date2018
dc.date.accessioned2023-09-26T22:41:32Z
dc.date.available2023-09-26T22:41:32Z
dc.identifierNABITY, S. A. et al. Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients. PLoS Neglected Tropical Diseases, v. 12, n. 2, e0006285, 2018.
dc.identifier1935-2727
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/25872
dc.identifier10.1371/journal.pntd.0006285
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8882001
dc.descriptionThe National Institutes of Health [grant numbers R44 AI072856, U01 AI088752, R01 AI052473, D43 TW00919, R44 A1072856], the Duke Global Health Institute, and the Brazilian National Council for Scientific and Technological Development (CNPq).
dc.descriptionEarly detection of leptospirosis with field-ready diagnostics may improve clinical management and mitigate outbreaks. We previously validated the point-of-care Dual Path Platform (DPP) for leptospirosis with sera in the laboratory. This prospective study compares the diagnostic accuracy and clinical utility of the DPP using finger stick blood (FSB) against the serum DPP, venous whole blood (VWB) DPP, IgM-ELISA, and clinical impression. We sequentially enrolled 98 patients hospitalized for acute febrile illnesses, of which we confirmed 32 by leptospirosis reference tests. Among syndromes consistent with classic leptospirosis, the FSB DPP showed similar sensitivity and specificity (Se 93% and Sp 80%), and positive and negative predictive values (PPV 74% and NPV 95%), to VWB DPP (Se 96%, Sp 75%, PPV 68%, and NPV 97%), serum DPP (Se 85%, Sp 87%, PPV 79%, and NPV 91%) and IgM-ELISA (Se 81%, Sp 100%, PPV 100%, and NPV 90%). The FSB DPP provided a favorable likelihood ratio profile (positive LR 4.73, negative LR 0.09) in comparison to other assays and clinical impression alone. Additionally, we identified four of five leptospirosis-associated meningitis patients by whole blood DPP, none of which clinicians suspected. This demonstrates potential for the DPP in routine detection of this less common syndrome. The FSB DPP demonstrated similar discrimination for severe human leptospirosis compared with serum assays, and it is a simpler option for diagnosing leptospirosis. Its performance in other epidemiological settings and geographic regions, and for detecting atypical presentations, demands further evaluation.
dc.formatapplication/pdf
dc.languageeng
dc.publisherPublic Library of Science
dc.rightsopen access
dc.subjectLeptospirose
dc.subjectMeningite
dc.subjectAcuracia dos dados
dc.subjectDiagnóstico
dc.subjectHumanos
dc.subjectTratamento
dc.subjectLeptospirosis
dc.subjectMeningitis
dc.subjectAccuracy of the data
dc.subjectDiagnostic
dc.subjectHumans
dc.subjectTreatment
dc.titleProspective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients
dc.typeArticle


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