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.
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