Abstract
Implementation of lateral flow devices (LFDs) for rabies antigen detection is expected to improve surveillance through the efficient detection of rabid animals in resource-limited settings; however, the use of LFDs for diagnosis remains controversial because some commercially available kits show low sensitivity. Therefore, we compared the diagnostic efficacy of three LFDs (ADTEC, Bionote, and Elabscience kits) paralleled with the direct fluorescent antibody test (dFAT) using fresh samples and investigated the diagnostic accuracies. To do so, we evaluated rabies-suspected samples submitted to the Regional Animal Disease Diagnostic Laboratory III, Philippines. Furthermore, we conducted real-time RT-PCR and sequencing to measure the accuracy of field laboratory diagnosis. The total number of animals submitted during this study period was 184 cases, including negative control samples. Of these, 53.9% (84 cases) were positive in the dFAT. Dogs were the most common rabies-suspected animal (n = 135). The sensitivities of the ADTEC and Bionote kits were 0.88 (74 cases) and 0.95 (80 cases), respectively. The specificity of both kits was 1.00 (100 cases). Furthermore, the sensitivity and specificity of the ADTEC kit after directly homogenizing the samples in assay buffer without dilution in phosphate-buffered saline (ADTEC kit DM) were 0.94 (79 cases) and 1.00 (100 cases), respectively. By contrast, there were no positive results using the Elabscience kit among all dFAT-positive samples. The sensitivity and specificity of LFDs make these tests highly feasible if properly used. Therefore, LFD tests can be used to strengthen the surveillance of rabies-infected animals in endemic and resource-limited settings.
Highlights
Rabies is caused by lyssaviruses, among which the rabies virus acts as the main etiological agent of human rabies
lateral flow devices (LFDs) may positively contribute to accurate data reporting, the use of LFDs for definitive diagnosis remains controversial because some LFDs showed inadequate ability
We evaluated the diagnostic accuracy of three LFDs (ADTEC, Bionote, and Elabscience kits) paralleled with the direct fluorescent antibody test and real-time RT-PCR using fresh samples and investigated discrepancies among these tests
Summary
Rabies is caused by lyssaviruses, among which the rabies virus acts as the main etiological agent of human rabies. There has been a dramatic decrease in the number of dog-mediated human rabies cases in the western hemisphere because of effective mass dog vaccination in addition to the control of the dog population [3,4,5]. Controlling rabies in dogs is essential to eradicate dog-mediated human rabies deaths [6]. Mass dog vaccination is included in the first phase of this activity because it is the most cost-effective strategy to control and eventually eliminate rabies. Surveillance and epidemiology data are essential to design effective and economic strategies, such as focusing on areas where rabies is endemic. It might contribute to the improvement of surveillance that is lacking in the majority of rabies-endemic countries
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