Lateral-flow immunoassay as a diagnostic test for influenza type A and B in children
Abstract
Background The diagnosis of influenza remains difficult toestablish because of its similar symptoms to those of respiratory
infection caused by other viruses. The “gold standard†for the
diagnosis of influenza is viral culture, which takes time to gain
the result and is expensive as well. A simple, rapid, and easily
used tool for detection of influenza virus type A and B is needed.
Objective To assess the accuracy of lateral-flow immunoassay with
Quick Vue Influenza A+B ® in detecting influenza virus of type
A and B.
Methods This was an observational study designed for diagnostic
test. The subjects were children aged 0-14 years old presenting
with acute respiratory infection in primary Health Care Jetis ,
Godean I, Godean II and Prof. Dr. Sardjito Hospital Yogyakarta,
from October 2005 to May 2007. Specimens were collected from
both the anterior nares and the throat by physicians for lateral-
flow immunoassay with Quick Vue Influenza A+B ® and viral
culture as gold standard. Lateral-flow immunoassay was done in
each study centre, nasal specimen was placed in an extraction
reagent tube and sent to NAMRU II laboratory.
Results There were 255 children enrolled in this study. Lateral-
flow immunoassay by Quick Vue Influenza A+B ® has sensitivity
70% (CI95% 6;83%), specificity 93% (CI95% 90;97%), positive
predictive value 68% (CI95% 54;82%), negative predictive value
94% (CI95% 91;97%), positive likelihood ratio 10,56 (CI95%
6,14;18,19) and negative likelihood ratio 0,32 (CI95% 0,21; 0,51).
Conclusion Lateral-flow immunoassay (Quick Vue Influenza
A+B ® ), nasal swab specimen is not accurate to detect influenza
virus A and B in children.
References
Clinical signs and symptoms predicting influenza infection.
Arch Intern Med 2000;160:3243-7.
2. Ruest A, Michaud S, Deslandes S, Frost EH. Comparison
of the Directigen Flu A+B Test, the Quick Vue Test and
clinical case definition to vital culture and reverse
transcription-PCR for Rapid Diagnosis of Influenza Virus
Infection. J Clin Micro 2003;41:3487-93.
3. Boivin G, Hardy I, Telle G, Maziade J. Predicting influenza
infections during epidemics with use of a clinical case
definition. Clin Infect Dis 2000;31:1166-9.
4. Wright P. Influenza Viruses. In: Behrman RE, Kliegman RM,
Jenson, HB, editors. Nelson textbook of Pediatrics. 17 th
edition. Philadelphia: Saunders; 2004. p. 1072-4.
5. Moscona A. Neuraminidase inhibitors for influenza. N Engl
J Med 2005;353:1363-73.
6. Poehling KA, Yuwei Z, Tang YW, and Edwards K. Accuracy
and impact of a point-of-care rapid influenza test in young
children with respiratory illnesses. Arch Pediatr Adolesc Med
2006;160:713-8.
7. Cazacu AC, Greer J, Taherivand M, Demmler GJ. Comparison
of lateral flow immunoassay and enzyme immunoassay with
viral culture for rapid detecting of influenza virus in nasal wash
specimens for children. J Clin Microbiol 2003;2132-4.
8. Bridges BC, Harper SA, Fukuda K, Uyeki TM, Cox NJ,
Singleton JA. Prevention and control of influenza:
recommendations of the advisory committee on
immunization Practices (ACIP). MMWR 2002;5:1–31.
9. The Advisory Committee on Immunization Practices
(ACIP). Update on the ACIPS’s recommendation. Influenza
Asian Focus Newsletter, 2004; volume 1, Issue 4.
10. Beckett CG, Kosasih H, Ma’roef C, Listiyaningsih E., Iqbal
RF, Elyazar, et al. Influenza Surveillance in Indonesia: 1999–
2003. Clinical Infectious Diseases 2004;39:443–9.
11. World Health Organization. Reagents for Influenza Virus
Diagnosis 2006. Australia: WHO collaborating centre for
reference and research on Influenza. 2005.
12. Zambon M, Hays J, Webster A, Newman R, and Keene O.
Diagnosis of influenza in the community : relationship of
clinical diagnosis to confirmed. 2001.
13. Covalciuc KA, K.H. Webb, and C. A. Carlson. Comparison
of four clinical specimen types for detection of influenza A
and B viruses by optical immunoassay (FLU OIA test) and
cell culture methods. J. Clin. Microbiol 1999;37:3971–4.
14. Heikkinen T, Salmi AA, and Ruuskanen O Comparative
study of nasopharyngeal aspirate and nasal swab specimens
for detection of influenza. BMJ 2001;322:138.
15. Jawetz E, Melnick JL, and Adelberg. Medical Microbiology.
22 nd edition. California : Lange medical publications; 2002.
p. 459–69.
16. Cherian T, Bobo L, Steinhoff MC, Karron RA and Yolken
RH. Use of PCR-enzyme immunoassay for identification of
influenza A virus matrix RNA in clinical samples negative
for cultivable virus. J Clin Microbiol 1994;32:623-8.
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Accepted 2016-09-07
Published 2008-05-01