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Comparison of four methods for detection of rotavirus in faeces
O S Ibrahim1, D Sunderland, C A Hart
1Department of Medical Microbiology, University of Liverpool, UK.
Insights
This study compared four methods for detecting human rotavirus (HRV) in children. Latex agglutination offered the best sensitivity for diagnosing rotavirus gastroenteritis, though RNA-PAGE is a cost-effective alternative.
Area of Science:
- Medical Microbiology
- Virology
- Public Health
Background:
- Gastroenteritis in children is a significant public health concern.
- Human rotavirus (HRV) is a primary cause of severe diarrheal disease in infants and young children worldwide.
- Accurate and accessible diagnostic methods for HRV are crucial for effective patient management and epidemiological surveillance.
Purpose of the Study:
- To evaluate and compare the diagnostic performance of four distinct methods for detecting human rotavirus (HRV) in pediatric fecal samples.
- To identify the most suitable diagnostic approach for HRV detection, considering sensitivity, specificity, cost, and practicality in various settings.
Main Methods:
- Faecal samples from 325 children with gastroenteritis and 23 asymptomatic children were analyzed.
- Four diagnostic techniques were employed: WHO-ELISA, latex particle agglutination, electron microscopy, and polyacrylamide gel electrophoresis of HRV RNA (RNA-PAGE).
- Performance metrics including sensitivity and specificity were calculated for each method.
Main Results:
- Human rotavirus (HRV) was detected in 30% of symptomatic children and 9% of asymptomatic children using WHO-ELISA.
- Latex particle agglutination demonstrated the highest sensitivity (92%) but the lowest specificity (96%).
- Electron microscopy and RNA-PAGE exhibited high specificity (100%) but lower sensitivities (73% and 84%, respectively).
Conclusions:
- Latex particle agglutination is the simplest method for bedside detection of HRV, particularly in resource-limited tropical settings, despite its cost.
- RNA-PAGE presents a viable, cost-effective alternative with high specificity, offering additional epidemiological data.
- The choice of diagnostic method should balance sensitivity, specificity, cost, and logistical feasibility for accurate HRV diagnosis.
Abstract:
Faecal samples from 325 children with gastroenteritis and 23 children without gastroenteritis were examined for the presence of human rotavirus (HRV) using four different methods. Using the WHO-ELISA, HRV was found in the stools of 98 (30%) symptomatic and 2 (9%) asymptomatic children. A latex particle agglutination test had the highest sensitivity (92%) but the lowest specificity (96%). Both electron microscopy and polyacrylamide gel electrophoresis of HRV RNA (RNA-PAGE) were highly specific (100%) but of lower sensitivity (73% and 84% respectively). Of the four methods tested latex particle agglutination is the simplest and since it requires little extra equipment is ideally suited for bedside tests in tropical countries. It is, however, not cheap. An alternative is to use RNA-PAGE which will require some equipment and a power supply but which is relatively cheap and will also provide epidemiological data.