{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:40:30Z","timestamp":1773967230018,"version":"3.50.1"},"reference-count":18,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,9]]},"abstract":"<jats:p>We assessed the diagnostic accuracy of two immunochromatographic tests (ICTs), the Access Bio <jats:italic>CareStart<\/jats:italic> Scrub Typhus test (Somerset, NJ) (IgM), and the SD BIOLINE Tsutsugamushi test (Kyonggi-do, Republic of Korea) (IgG, IgM, or IgA) compared with indirect immunofluorescence assay (IFA) and real-time PCR results as reference tests using 86 paired acute and convalescent specimens from febrile patients. The sensitivity and specificity of the <jats:italic>CareStart<\/jats:italic> test were 23.3% (95% confidence interval [CI]: 11.8\u201338.6) and 81.4% (95% CI: 66.6\u201391.6), respectively, for acute specimens and 32.6% (95% CI: 19.1\u201348.5) and 79.1% (95% CI: 64.0\u201390.0), respectively, for convalescent specimens. For the SD BIOLINE test, sensitivity and specificity were 20.9% (95% CI: 10.0\u201336.0) and 74.4% (95% CI: 58.8\u201386.5), respectively, for acute specimens and 76.7% (95% CI: 61.4\u201388.2) and 76.7% (95% CI: 61.4\u201388.2), respectively, for convalescent specimens. The poor sensitivity obtained for both ICTs during this study when performed on acute specimens highlights the difficulties in prompt diagnosis of scrub typhus.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0435","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T20:08:14Z","timestamp":1444766894000},"page":"1168-1171","source":"Crossref","is-referenced-by-count":14,"title":["Diagnostic Accuracy Assessment of Immunochromatographic Tests for the Rapid Detection of Antibodies Against Orientia tsutsugamushi Using Paired Acute and Convalescent Specimens"],"prefix":"10.4269","volume":"93","author":[{"given":"Wanitda","family":"Watthanaworawit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Turner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Turner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ampai","family":"Tanganuchitcharnchai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suthatip","family":"Jintaworn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borimas","family":"Hanboonkunupakarn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen L.","family":"Richards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas P. J.","family":"Day","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart D.","family":"Blacksell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Nosten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Ann Trop Med Parasitol","first-page":"363","article-title":"Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study","volume":"100","author":"Suttinont","year":"2006"},{"key":"ref2","series-title":"Am J Trop Med Hyg","first-page":"497","article-title":"Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand","volume":"67","author":"Coleman","year":"2002"},{"key":"ref3","series-title":"PLoS Negl Trop Dis","first-page":"e888","article-title":"Arthropod borne disease: the leading cause of fever in pregnancy on the Thai\u2013Burmese border","volume":"4","author":"McGready","year":"2010"},{"key":"ref4","series-title":"Am J Trop Med Hyg","first-page":"108","article-title":"Causes of fever in adults on the Thai\u2013Myanmar border","volume":"74","author":"Ellis","year":"2006"},{"key":"ref5","series-title":"Clin Vaccine Immunol","first-page":"391","article-title":"Prospective evaluation of commercial antibody-based rapid tests in combination with a loop-mediated isothermal amplification PCR assay for detection of Orientia tsutsugamushi during the acute phase of scrub typhus infection","volume":"19","author":"Blacksell","year":"2012"},{"key":"ref6","series-title":"Clin Infect Dis","first-page":"391","article-title":"Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion","volume":"44","author":"Blacksell","year":"2007"},{"key":"ref7","series-title":"Southeast Asian J Trop Med Public Health","first-page":"91","article-title":"Patient and sample-related factors that effect the success of in vitro isolation of Orientia tsutsugamushi","volume":"38","author":"Luksameetanasan","year":"2007"},{"key":"ref8","series-title":"J Korean Med Sci","first-page":"672","article-title":"Improvement of the diagnostic sensitivity of scrub typhus using a mixture of recombinant antigens derived from Orientia tsutsugamushi serotypes","volume":"28","author":"Kim","year":"2013"},{"key":"ref9","series-title":"Clin Vaccine Immunol","first-page":"263","article-title":"Accuracy of AccessBio immunoglobulin M and total antibody rapid immunochromatographic assays for the diagnosis of acute scrub typhus infection","volume":"17","author":"Blacksell","year":"2009"},{"key":"ref10","series-title":"Am J Trop Med Hyg","first-page":"365","article-title":"Accuracy of rapid IgM-based immunochromatographic and immunoblot assays for diagnosis of acute scrub typhus and murine typhus infections in Laos","volume":"83","author":"Blacksell","year":"2010"},{"key":"ref11","series-title":"Am J Trop Med Hyg","first-page":"148","article-title":"Development of new, broadly reactive, rapid IgG and IgM lateral flow assays for diagnosis of scrub typhus","volume":"87","author":"Silpasakorn","year":"2012"},{"key":"ref12","series-title":"Am J Trop Med Hyg","first-page":"351","article-title":"Development of a quantitative real-time polymerase chain reaction assay specific for Orientia tsutsugamushi","volume":"70","author":"Jiang","year":"2004"},{"key":"ref13","series-title":"DIAGT: Stata Module to Report Summary Statistics for Diagnostic Tests Compared to True Disease Status","author":"Seed","year":"2001"},{"key":"ref14","series-title":"Biometrics","first-page":"159","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977"},{"key":"ref15","series-title":"Am J Trop Med Hyg","first-page":"532","article-title":"Humoral and cellular responses in scrub typhus patients reflecting primary infection and reinfection with Rickettsia tsutsugamushi","volume":"31","author":"Bourgeois","year":"1982"},{"key":"ref16","series-title":"J Clin Microbiol","first-page":"1169","article-title":"Usefulness of eschar PCR for diagnosis of scrub typhus","volume":"44","author":"Lee","year":"2006"},{"key":"ref17","series-title":"Am J Trop Med Hyg","first-page":"368","article-title":"Diagnosis of scrub typhus","volume":"82","author":"Koh","year":"2010"},{"key":"ref18","series-title":"Am J Trop Med Hyg","first-page":"308","article-title":"A prospective evaluation of real-time PCR assays for the detection of Orientia tsutsugamushi and Rickettsia spp. for early diagnosis of rickettsial infections during the acute phase of undifferentiated febrile illness","volume":"89","author":"Watthanaworawit","year":"2013"}],"container-title":["The American Society of Tropical Medicine and 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