Comparison of Latex Agglutination with Enzyme Immunoassay for Detection of Rotavirus in Children with Acute Diarrhea in Diyala Province, Iraq

Abstract

Rotavirus (RV) is the most important etiological agent of diarrhea in children under 5 years old, mainly in developing countries. The laboratory diagnosis is usually based on detection of viral antigen using enzyme immunoassay or direct latex agglutination techniques. Objectives: To compare the sensitivity and specificity of enzyme immunoassay versus direct agglutination test for the detection of rotavirus in stool of children less than 5 years of age with acute diarrhea in Diyala province. Patients and methods: The present study was conducted during the period from 1/August/2012 to 30/November/2013. 120 patients with acute diarrhea were included. The patients attended Al-Batool Maternity and children Teaching Hospital and other Primary Health Care Centers in Baquba, the center of Diyala province. Seventy (58.3%) patients were males and 50 (41.7%) were females. The age range was 2 months to 5 years. Information regarding age, sex, residence, type of feeding and source of drinking water were collected. Detection of RV in stool specimens using direct agglutination test (Diaspot-USA) was performed as soon as possible after collection. The enzyme linked immunosorbant assay (ELISA) was carried out using the commercially available kit (DRG-Germany). Data were statistically analyzed and P value < 0.05 was considered significant. Results: The results showed that the detection rate of RV in stool specimens by DAT and ELISA were 70% and 93.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive values of DAT was 75.56%, 66.67%, 97.22%, and 15.39% respectively, and for ELISA was 91.3%, 66.67%, 97.67%, and 33.33% respectively. Spearman's correlation analyses revealed that the age group 10-15 months was significantly affected (P= 0.046). Conclusion: Rotavirus antigen detection by EIA is a rapid, sensitive, and specific method, and could be used in large scale application for screening stool samples of patients with acute diarrhea.