Utility of Urine Reagent Strips for Analysis of Cerebrospinal Fluid in Emergency Settings: A Cross-sectional Study

Abstract

Introduction: Meningitis is the inflammation of the meninges which covers brain and spinal cord, which if not identified on time will result in permanent neurological deficit or death. Mainly divided into septic and aseptic meningitis, differentiating these two and timely intervention would prevent neurological damage. Cerebrospinal Fluid (CSF) analysis helps to arrive at a diagnosis of meningitis which requires relevant trained staff and adequately equipped laboratory These are not available in most of the healthcare centers in rural settings. Aim: To evaluate the role of urinary reagent strip method in rapid analysis of CSF to assist the clinician in the bedside diagnosis or exclusion of meningitis. To compare the values obtained by rapid method with that of results obtained by automated analyser. Materials and Methods: This is a cross sectional study done in Pathology lab of Mandya Institute of Medical Sciences, district hospital, Karnataka, Mandya, India. A total of 30 samples evaluated during the period of two months in 2019. (15th Aug- 15th Oct).Cerebrospinal fluid analysis were tested using combur- 10 urinary reagent strip and microscopy examination as reference standards. Automated analysers were used for the analysis of protein and glucose; and neubauer’s counting chamber was used for leucocytes count. Results: The sensitivity and specificity of urinary strips in the analysis of cerebrospinal fluid for glucose, protein, leucocytes is 50.00%, 41.67%, 78.57% and 92.31%, 88.89%, 68.75% respectively. Diagnostic accuracy of urinary strip tests for glucose, protein and leucocytes are 83.33% 93.34% 86.67% respectively. Conclusion: The study shows the reliable sensitivity and specificity in some parameters hence can be used in remote settings.