Evaluation of IgM LAT and IgM ELISA as compared to microscopic agglutination test (MAT) for early diagnosis of Leptospira sp

Leptospirosis is a worldwide zoonotic disease caused by spirochetes of the genus Leptospira. The clinical manifestation of leptospirosis is non-specific and frequently misdiagnosed as other illnesses. The aim of this study was to compare the diagnostic accuracies of two commercial tests for early diagnosis of Leptospira species: the IgM latex agglutination test (IgM LAT) and the IgM enzyme-linked immunosorbent assay (IgM ELISA). A total of 140 serum samples were obtained from patients suspected of leptospirosis at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). These serum samples were tested for the presence of Leptospira sp. using IgM LAT, IgM ELISA and MAT. From Table 1, IgM LAT showed 21% (n = 29) positive, 18% (n = 25) inconclusive and 61% (n = 86) negative, while IgM ELISA showed 6% (n = 8) positive, 6% (n = 8) inconclusive, 88% (n = 124) negative and MAT showed 11% (n = 16) positive, 47% (n = 65) inconclusive, 42% (n = 59) negative. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of IgM LAT were 68.8%, 57.6%, 30.6% and 87.2% respectively, while for IgM ELISA they were 37.5%, 89.8%, 50% and 84.1%, respectively as compared to MAT (Table 2). The results showed that IgM LAT had higher sensitivity but lower specificity compared to IgM ELISA. In conclusion, IgM LAT can be useful as an early screening test for early diagnosis of Leptospira sp., while IgM ELISA is a suitable method for reducing false negative detection of Leptospira sp. As both tests show moderate percentages (~65%) in accuracy, an additional test is required for better detection of Leptospira sp.