Publication: Accuracy of commercially available creactive protein rapid tests in the context of undifferentiated fevers in rural Laos
Issued Date
2016
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Infectious Diseases. Vol.16, (2016), 61
Suggested Citation
Koukeo Phommasone, Thomas Althaus, Phonesavanh Souvanthong, Khansoudaphone Phakhounthong, Laxoy Soyvienvong, Phatthaphone Malapheth, Mayfong Mayxay, Pavlicek, Rebecca L., Paris, Daniel H., David Dance, Paul Newton, Yoel Lubell Accuracy of commercially available creactive protein rapid tests in the context of undifferentiated fevers in rural Laos. BMC Infectious Diseases. Vol.16, (2016), 61. doi:10.1186/s12879-016-1360-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3227
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Title
Accuracy of commercially available creactive protein rapid tests in the context of undifferentiated fevers in rural Laos
Abstract
Background: C-Reactive Protein (CRP) has been shown to be an accurate biomarker for discriminating bacterial
from viral infections in febrile patients in Southeast Asia. Here we investigate the accuracy of existing rapid
qualitative and semi-quantitative tests as compared with a quantitative reference test to assess their potential for
use in remote tropical settings.
Methods: Blood samples were obtained from consecutive patients recruited to a prospective fever study at three
sites in rural Laos. At each site, one of three rapid qualitative or semi-quantitative tests was performed, as well as a
corresponding quantitative NycoCard Reader II as a reference test. We estimate the sensitivity and specificity of the
three tests against a threshold of 10 mg/L and kappa values for the agreement of the two semi-quantitative tests
with the results of the reference test.
Results: All three tests showed high sensitivity, specificity and kappa values as compared with the NycoCard Reader II.
With a threshold of 10 mg/L the sensitivity of the tests ranged from 87–98 % and the specificity from 91–98 %. The
weighted kappa values for the semi-quantitative tests were 0.7 and 0.8.
Conclusion: The use of CRP rapid tests could offer an inexpensive and effective approach to improve the targeting of
antibiotics in remote settings where health facilities are basic and laboratories are absent. This study demonstrates that
accurate CRP rapid tests are commercially available; evaluations of their clinical impact and cost-effectiveness at point
of care is warranted.