Evaluation of the modified-indirect hemagglutinin assay using chicken red blood cells as a routine melioidosis detection in Maharaj Nakorn Chiang Mai Hospital
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Abstract
Background: Melioidosis is a life-threatening illness caused by Burkholderia pseudomallei, which is endemic throughout Thailand. The indirect hemagglutination assay (IHA), a serological test, is widely used to diagnose melioidosis. However, the conventional IHA available in Thailand still requires more than 4 hours for measurement time, limiting its efficiency in clinical settings. This study addresses the need for a quicker and more efficient diagnostic method for melioidosis.
Objective: The study aimed to evaluate the agreement between a modified indirect hemagglutination (modified IHA) assay and the commercially available IHA kit for routine melioidosis diagnosis at Maharaj Nakorn Chiang Mai Hospital. Chicken red blood cells were used instead of sheep red blood cells to reduce diagnostic time and costs while maintaining high accuracy and reliability.
Materials and methods: A total of 368 serum samples were tested using the modified IHA assay, which utilized chicken red blood cells instead of sheep red blood cells used in the commercial IHA kit. The results were compared with those of the commercial IHA kit for melioidosis detection.
Results: The modified IHA assay showed 99.46% agreement, with an excellent kappa value of 0.98, compared to the commercial kit. In the validation step, the modified IHA assay correctly identified 100% (54 out of 54) of positive samples and 100% (54 out of 54) of negative samples. However, 0.63% (2 out of 320) false positives were observed in the diagnostic samples with the modified IHA assay.
Conclusion: The modified IHA assay may serve as a valuable alternative for the routine diagnosis of melioidosis because it is less time-consuming and more cost-effective than the commercial IHA kit. However, further studies with more clinical samples are warranted to confirm its utility.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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