Related Experiment Video
Updated: Dec 17, 2025
Developing a Salivary Antibody Multiplex Immunoassay to Measure Human Exposure to Environmental Pathogens
Published on: September 12, 2016
Cross-sectional study of population-specific streptococcal antibody titres in Uganda
Emmy Okello1, Meghna Murali2, Joselyn Rwebembera1
1Uganda Heart Institute Ltd, Kampala, Uganda.
Objective:
Despite substantial variation of streptococcal antibody titres among global populations, there is no data on normal values in sub-Saharan Africa. The objective of this study was to establish normal values for antistreptolysin O (ASO) and antideoxyribonuclease B (ADB) antibodies in Uganda.
Design:
This was an observational cross-sectional study.
Setting:
This study was conducted at Mulago National Referral Hospital, which is located in the capital city, Kampala, and includes the Uganda Heart Institute.
Patients:
Participants (aged 0-50 years) were recruited. Of 428 participants, 22 were excluded from analysis, and 183 (44.4%) of the remaining were children aged 5-15 years.
Main Outcome Measures:
ASO was measured in-country by nephelometric technique. ADB samples were sent to Australia (PathWest) for analysis by enzyme inhibition assay: 80% upper limit values were established.
Results:
The median ASO titre in this age group was 220 IU/mL, with the 80th percentile value of 389 IU/mL. The median ADB titre in this age group was 375 IU/mL, with the 80th percentile value of 568 IU/mL.
Conclusions:
The estimated Ugandan paediatric population standardised 80% upper-limit-of-normal ASO and ADB titres is higher than many global populations. Appropriateness of using population-specific antibody cutoffs is yet to be determined and has important implications for the sensitivity and specificity of rheumatic fever diagnosis.
