{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:16:43Z","timestamp":1783113403053,"version":"3.54.6"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009104","name":"Department of Health Research, India","doi-asserted-by":"publisher","award":["Ref. No. VIR\/Covid\u201019\/36\/2020\/ECD\u20101\/E\u2010office:117467"],"award-info":[{"award-number":["Ref. No. VIR\/Covid\u201019\/36\/2020\/ECD\u20101\/E\u2010office:117467"]}],"id":[{"id":"10.13039\/501100009104","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n \n Scrub typhus, caused by\n \n Orientia tsutsugamushi<\/jats:italic>\n <\/jats:styled-content>\n , is a significant contributor to acute undifferentiated febrile illness in South and Southeast Asia. Laboratory confirmation of infection has a crucial role in timely management; nevertheless, lack of standardisation in inter\u2010laboratory performance of IgM enzyme\u2010linked immunosorbent assay (ELISA) has been a long\u2010standing challenge. In resource\u2010constrained countries, quality assurance schemes have an important role in improving laboratory performance. The aim of this pilot study was to assess the applicability of dried serum spots (DSS) as a suitable sample format for quality assurance schemes of\n \n O. tsutsugamushi<\/jats:italic>\n <\/jats:styled-content>\n IgM ELISA in India.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Well\u2010characterised positive and negative serum samples were processed into DSS panels and were systematically validated for homogeneity and short\u2010term stability according to ISO\/IEC 17043 and ISO 13528 using two commercially available IgM ELISA kits (InBios International Inc. and J. Mitra Scrub Typhus IgM Microlisa). Distribution was done for 10 participating laboratories across India. The laboratories tested DSS panels under routine diagnostic conditions using standardised protocols. The results were evaluated for qualitative accuracy, inter\u2010laboratory concordance and overall performance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n DSS panels exhibited a high degree of homogeneity and stability under simulated transport and storage conditions, thereby not requiring cold chain distribution. On initial testing, 8 of 10 laboratories (80%) showed complete qualitative concordance across the five\u2010sample panel. Following repeat testing and procedural review, all laboratories achieved concordant qualitative results, with minor disagreement noted only in borderline reactive samples.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Dried serum spots are a feasible, reliable and cost\u2010effective alternative to conventional liquid serum for external quality assurance of\n \n O. tsutsugamushi<\/jats:italic>\n <\/jats:styled-content>\n IgM ELISA. The initial discordance observed underscores the importance of EQA in identifying procedural variability, while the final concordance confirms the robustness and suitability of DSS for EQA implementation in resource\u2010limited, endemic settings like India.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tmi.70132","type":"journal-article","created":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T23:34:47Z","timestamp":1774222487000},"page":"868-874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dried Serum Spots for External Quality Assurance of Scrub Typhus\n IgM<\/scp>\n Serology: A Multicentre Pilot Study From India"],"prefix":"10.1111","volume":"31","author":[{"given":"Haripriya","family":"Sivakumar","sequence":"first","affiliation":[{"name":"Department of Microbiology JIPMER Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinakaran","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"Regional Virus Research and Diagnostic Laboratory (RVRDL), Department of Microbiology JIPMER Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratchagadasse Vimal","family":"Raj","sequence":"additional","affiliation":[{"name":"Regional Virus Research and Diagnostic Laboratory (RVRDL), Department of Microbiology JIPMER Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2058-2672","authenticated-orcid":false,"given":"Ferdinamarie Sharmila","family":"Philomenadin","sequence":"additional","affiliation":[{"name":"Regional Virus Research and Diagnostic Laboratory (RVRDL), Department of Microbiology JIPMER Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmanmeet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amity Institute of Public Health Amity University Noida India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8984-3332","authenticated-orcid":false,"given":"Rahul","family":"Dhodapkar","sequence":"additional","affiliation":[{"name":"Department of Microbiology JIPMER Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmm.IJMM_19_147"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005838"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2017.05.027"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm515"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.52.9.633"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2023.113519"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26083857"},{"key":"e_1_2_12_9_1","volume-title":"Conformity Assessment\u2014General Requirements for Proficiency Testing","author":"ISO\/IEC 17043:2023","year":"2023"},{"key":"e_1_2_12_10_1","volume-title":"Statistical Methods for Use in Proficiency Testing by Interlaboratory Comparison","author":"ISO 13528:2022","year":"2022"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/131.5.1631S"},{"issue":"6","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1515\/CCLM.2006.133","article-title":"External Quality Assessment: An Effective Tool for Clinical Governance in Laboratory Medicine","volume":"44","author":"Sciacovelli L.","year":"2006","journal-title":"Clinical Chemistry and Laboratory Medicine: CCLM\/FESCCS"},{"key":"e_1_2_12_13_1","first-page":"48","article-title":"Clinical Implications of Laboratory Quality Assurance","volume":"449","author":"Okane M. 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