Performance Assessment of a Lateral Flow Rapid Test (SsRapid®) Compared with Two Commercial ELISAs in Detecting Strongyloides Infection

Nor Suhada Anuar Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia;

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Anizah Rahumatullah Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia;

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Norashikin Samsudin Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia;
Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia;
Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia;

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Zeehaida Mohamed Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia;
Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia;

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Emelia Osman Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia;

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Nik Zairi Zakaria Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia;
Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia;

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Hussain Ahmad Department of Microbiology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan

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Rahmah Noordin Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia;

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ABSTRACT.

Approximately 600 million people worldwide are infected with Strongyloides stercoralis. Many diagnostic laboratories use serology to detect the infection. SsRapid® is a prototype IgG4 lateral flow test based on NIE recombinant protein. We compared SsRapid with two commercial IgG-ELISAs (Bordier and Euroimmun) using five sera groups (G1–5, N = 170). Healthy individuals from nonendemic areas (G1, N = 33) and Strongyloides larvae-positive patients (G2, N = 20) showed no significant difference (P > 0.05) among the three assays. The group of other parasitic infections (G3) showed that SsRapid results were more concordant with Bordier ELISA (73%, 35/48) than Euroimmun ELISA (65%, 31/48). In corticosteroid-treated cancer patients who were polymerase chain reaction–positive for Strongyloides (G4, N = 25), SsRapid showed a higher detection rate (28%, 7/25) than both ELISAs (4%, 1/25). Meanwhile, SsRapid showed significantly less infection prevalence among the endemic area population (G5) than the ELISAs. Overall, SsRapid showed good performance in detecting Strongyloides infection compared with the commercial IgG-ELISAs.

Author Notes

Address correspondence to Rahmah Noordin, Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia. E-mail: rahmah8485@gmail.com

Financial support: This study was funded by the Malaysian Ministry of Higher Education (MOHE) MyLAB grant 1/2018 (No 203.CIPPM.6730142).

Disclosure: R. Noordin and NS Anuar are named as inventors of SsRapid® test, which has been licensed by the Universiti Sains Malaysia to Accobiotech Sdn. Bhd.

Authors’ addresses: Nor Suhada Anuar, Anizah Rahumatullah, and Rahmah Noordin, Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia, E-mails: norsuhada@usm.my, anizahrahumatullah@usm.my, and rahmah8485@gmail.com. Norashikin Samsudin, Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia, Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia, and Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia, E-mail: snorashikin@unimas.my. Zeehaida Mohamed and Nik Zairi Zakaria, Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia, and Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia. E-mails: zeehaida@usm.my and zairikck@usm.my. Emelia Osman, Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia, E-mail: emelia.osman@ukm.edu.my. Hussain Ahmad, Department of Microbiology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan, E-mail: hussainahmad@awkum.edu.pk.

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