ArticleJournal of clinical microbiology2016
Optimal Cutoff and Accuracy of an IgM Enzyme-Linked Immunosorbent Assay for Diagnosis of Acute Scrub Typhus in Northern Thailand: an Alternative Reference Method to the IgM Immunofluorescence Assay.
Article in Journal of clinical microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03847870 (Background Seroprevalence of Rickettsial Infections in Myanmar), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Background Seroprevalence of Rickettsial Infections in Myanmar
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The validity of diagnostic cut-offs for commercial and in-house scrub typhus IgM and IgG ELISAs: A review of the evidence.PLoS neglected tropical diseases · 2019Pooled it
- Neglected rickettsial diseases in Southeast Asia: Twenty-five years of progress in surveillance, diagnostics, and clinical research.PLoS neglected tropical diseases · 2026Review
- Persistence of scrub typhus IgM and IgG antibodies among patients from Karnataka, India.Annals of medicine · 2025Article
- Diagnostic heterogeneity in scrub typhus serology: A scoping review of IFA thresholds and regional standardisation needs (2005-2024).PLoS neglected tropical diseases · 2025Article
- Article
- Estimating the Seroprevalence of Scrub Typhus in Nepal.Pathogens (Basel, Switzerland) · 2024Article
- Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis.PLoS neglected tropical diseases · 2024Article
- Longitudinal comparison of bacterial pathogen seropositivity among wet market vendors in the Lao People's Democratic Republic.One health (Amsterdam, Netherlands) · 2023Article
- Prevalence of and factors associated with scrub typhus exposure among the hill tribe population living in high incidence areas in Thailand: a cross-sectional study.BMC public health · 2023Article
- Serological Evidence of Scrub Typhus in Mizoram, North Eastern Region of India.Infectious diseases & clinical microbiology · 2022Article
- International Rickettsia Disease Surveillance: An Example of Cooperative Research to Increase Laboratory Capability and Capacity for Risk Assessment of Rickettsial Outbreaks Worldwide.Frontiers in medicine · 2021Review
- Diagnostic accuracy of an in-house Scrub Typhus enzyme linked immunoassay for the detection of IgM and IgG antibodies in Laos.PLoS neglected tropical diseases · 2020Article
- Clinical Characteristics and Outcome of Children Hospitalized With Scrub Typhus in an Area of Endemicity.Journal of the Pediatric Infectious Diseases Society · 2020Article
- Determination of cut-off and correlates of delay in treatment-seeking of febrile illness: a retrospective analysis.BMC public health · 2020Article
- Determination of Optimal Diagnostic Cut-Offs for the Naval Medical Research Center Scrub Typhus IgM ELISA in Chiang Rai, Thailand.The American journal of tropical medicine and hygiene · 2019Article
- Diagnosis of Murine Typhus by Serology in Peninsular Malaysia: A Case Report Where Rickettsial Illnesses, Leptospirosis and Dengue Co-Circulate.Tropical medicine and infectious disease · 2019Article
- Awareness and Work-Related Factors Associated with Scrub Typhus: A Case-Control Study from South Korea.International journal of environmental research and public health · 2018Article
- Evaluation of a broad-ranging and convenient enzyme-linked immunosorbent assay using the lysate of infected cells with five serotypes of Orientia tsutsugamushi, a causative agent of scrub typhus.BMC microbiology · 2017Article
- Scrub typhus: risks, diagnostic issues, and management challenges.Research and reports in tropical medicine · 2017Review
- Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests.Journal of clinical and diagnostic research : JCDR · 2016Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
The enzyme-linked immunosorbent assay (ELISA) has been proposed as an alternative serologic diagnostic test to the indirect immunofluorescence assay (IFA) for scrub typhus. Here, we systematically determine the optimal sample dilution and cutoff optical density (OD) and estimate the accuracy of IgM ELISA using Bayesian latent class models (LCMs). Data from 135 patients with undifferentiated fever were reevaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar and tested with a blood culture for Orientia tsutsugamushi, three different PCR assays, and an IgM IFA. The IgM ELISA was performed for every sample at sample dilutions from 1:100 to 1:102,400 using crude whole-cell antigens of the Karp, Kato, and Gilliam strains of O. tsutsugamushi developed by the Naval Medical Research Center. We used Bayesian LCMs to generate unbiased receiver operating characteristic curves and found that the sample dilution of 1:400 was optimal for the IgM ELISA. With the optimal cutoff OD of 1.474 at a sample dilution of 1:400, the IgM ELISA had a sensitivity of 85.7% (95% credible interval [CrI], 77.4% to 86.7%) and a specificity of 98.1% (95% CrI, 97.2% to 100%) using paired samples. For the ELISA, the OD could be determined objectively and quickly, in contrast to the reading of IFA slides, which was both subjective and labor-intensive. The IgM ELISA for scrub typhus has high diagnostic accuracy and is less subjective than the IgM IFA. We suggest that the IgM ELISA may be used as an alternative reference test to the IgM IFA for the serological diagnosis of scrub typhus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.