ArticleThe American journal of tropical medicine and hygiene2016
Redefining Gold Standard Testing for Diagnosing Leptospirosis: Further Evidence from a Well-Characterized, Flood-Related Outbreak in Sri Lanka.
Article in The American journal of tropical medicine and hygiene, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge.BMC infectious diseases · 2024Pooled it
- Diagnostic accuracy of genetic markers and nucleic acid techniques for the detection of Leptospira in clinical samples: A meta-analysis.PLoS neglected tropical diseases · 2020Pooled it
- Nucleic acid and antigen detection tests for leptospirosis.The Cochrane database of systematic reviews · 2019Pooled it
- Estimating the burden of leptospirosis in Sri Lanka; a systematic review.BMC infectious diseases · 2019Pooled it
- Urban Leptospiral Meningoencephalitis Associated With Bottle Recycling: A Case Report and Literature Review.Cureus · 2026Article
- Subclinical Leptospiral Infections and Antibody Waning During Pregnancy: A Population-Based Cohort Study from Rural Sri Lanka.The American journal of tropical medicine and hygiene · 2026Article
- Clinical presentation and laboratory findings: key indicators for early diagnosis and severity prediction of leptospirosis in Sri Lanka.BMC infectious diseases · 2026Article
- Seroprevalence of equine leptospirosis in Poland (2019-2023).Equine veterinary journal · 2026Article
- Suspected myocarditis resulting from leptospirosis: A case report from Iran.SAGE open medical case reports · 2026Article
- Tackling the ST elevation in leptospirosis: A double-edged sword between bleeding and thrombosis - A case report.Narra J · 2025Article
- Diagnostic Advances in Leptospirosis: A Comparative Analysis of Paraclinical Tests with a Focus on PCR.Microorganisms · 2025Review
- Evaluation of Serological Tests for Different Disease Stages of Leptospirosis Infection in Humans.Tropical medicine and infectious disease · 2024Article
- Serologically Confirmed Human Leptospirosis in Colombia, 2015-2020.The American journal of tropical medicine and hygiene · 2024Article
- Article
- Seroprevalence of leptospirosis among blood donors in an endemic area.Scientific reports · 2023Article
- Artificial intelligence in differentiating tropical infections: A step ahead.PLoS neglected tropical diseases · 2022Article
- Comparison of the Serion IgM ELISA and Microscopic Agglutination Test for diagnosis of Leptospira spp. infections in sera from different geographical origins and estimation of Leptospira seroprevalence in the Wiwa indigenous population from Colombia.PLoS neglected tropical diseases · 2022Article
- Diagnostic method-based underestimation of leptospirosis in clinical and research settings; an experience from a large prospective study in a high endemic setting.PLoS neglected tropical diseases · 2022Article
- Enzyme immunoassays (EIA) for serodiagnosis of human leptospirosis: specific IgG3/IgG1 isotyping may further inform diagnosis of acute disease.PLoS neglected tropical diseases · 2022Article
- SARIMA and ARDL models for predicting leptospirosis in Anuradhapura district Sri Lanka.PloS one · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
Abstract
A gap in the leptospirosis field remains the lack of well-characterized sample collections that allow for comparison of new methods to standard ones. In the context of a flood-related outbreak of leptospirosis evaluated in Anuradhapura, Sri Lanka, a specimen bank was obtained with detailed metadata accompanied by gold standard diagnostic test results. Blood samples collected on admission and 14 days later from suspected cases of leptospirosis were tested using microscopic agglutination test (MAT) (17 serovars), an in-house enzyme-linked immunosorbent assay (ELISA) using a locally obtained strain of Leptospira kirschneri as sonicated antigen, a commercially available ELISA based on sonicated Leptospira biflexa, and a quantitative polymerase chain reaction (qPCR) assay targeting the pathogenic Leptospira-specific 16S rRNA gene. Of 62 patients presenting within the first 2 days of illness, 31 had confirmed leptospirosis based either on paired-sample MAT or qPCR. During the acute phase, qPCR was most sensitive, detecting 74% of definitively diagnosed cases; immunoglobulin G (IgG) ELISA (in-house), IgG ELISA (commercial), and MAT had sensitivities of 35.5%, 12.0%, and 22.6%, respectively, in detecting definitively diagnosed cases using acute phase serum. Of 40 patients with paired sera, 10 were qPCR positive. Of these, five samples were negative by paired-sample MAT. Of the 11 MAT-positive samples, only five were detected using qPCR confirming that both tests are needed for maximal sensitivity. Regional leptospiral serovar-specific IgG ELISA was superior to MAT. Knowing the regionally dominant serovars improves serological sensitivity in the analysis of acute specimens by ELISA, but qPCR was most sensitive in this patient population.
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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.