Rapid Diagnosis of Leptospirosis by IgM ELISA in Resource Poor Settings. P.

Background & Objectives: Early and accurate diagnosis of leptospirosis is important for proper and prompt treatment, which is life saving for patients with severe illness. IgM ELISA is particularly useful in making an early diagnosis, since it is positive in the first week of illness, a time when the clinical manifestations may be nonspecific. This study was done to evaluate the prevalence of leptospirosis in Aligarh and to compare the efficacy of IgM ELISA to PCR and MAT as a rapid, sensitive and cost effective diagnostic tool for leptospirosis. Methods: Patients with acute febrile illness, acute renal failure and acute hepatitis were included in the study. Clinical & epidemiological history was evaluated on the basis of modified Faine’s criteria. ELISA, MAT and PCR using G1/G2 primer which amplifies a 285 bp fragment was done for confirmation of diagnosis. Results: Thirty one (14.9%) patients were found positive for specific anti-leptospira IgM antibodies by ELISA. On comparing the results of IgM ELISA to MAT the sensitivity was 100% while specificity was 87.6%, while it was 100% and 97.3% respectively in relation to PCR. None of the patients had a Faine’s score > 25 and 21(67.7%) patients had a score between 20 - 25. Interpretations &Conclusions: ELISA is a cost-effective, sensitive and specific test that can be used as a first line diagnostic test for early diagnosis of leptospirosis.