Reagent strips test: A simplified method for prompt analysis of cerebrospinal fluid in neurological disorders in emergency

Abstract

IntroductionThe initial examination of cerebrospinal fluid (CSF) for proteins, glucose, and leukocytes, is still the gold standard investigation in some neurological conditions like meningitis. Aims and objective of the present study were to determine the accuracy of urinary reagent strip for semi-quantitative analysis of protein, glucose, leucocytes and erythrocytes in CSF along with its role in emergency for rapid diagnosis of neurological conditions. Materials and methods360 samples of CSF were received in emergency laboratory of a tertiary care hospital in a period of 6 months. All CSF samples were subjected to two types of tests-the definitive test and the index test. CSF microscopy for leucocyte and erythrocyte as well as biochemistry tests for protein and glucose on automated biochemistry analyser were considered as definitive test. The index test for protein, glucose, leucocyte and erythrocyte for the same sample was conducted by Combur-10 urinary reagent strip. ResultThe strip test showed a sensitivity of 99% and a specificity of 54% for proteins. With respect to glucose, the strip was highly sensitive (98%) as well as highly specific (92%).It showed a high sensitivity and specificity for leukocytes ≥ 10 cells/cumm i.e.100% and 96% respectively. For CSF erythrocytes sensitivity and specificity was 100% ConclusionUrinary reagent strip can be used routinely for rapid analysis of CSF. If implemented, this technique will be useful especially in emergency settings as well as in areas with limited resources.