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. 1988 Aug;101(1):159–171. doi: 10.1017/s0950268800029320

Serological tests in leprosy. The sensitivity, specificity and predictive value of ELISA tests based on phenolic glycolipid antigens, and the implications for their use in epidemiological studies.

P J Burgess 1, P E Fine 1, J M Ponnighaus 1, C Draper 1
PMCID: PMC2249338  PMID: 3042436

Abstract

This paper examines the sensitivity and specificity of two ELISA assays for IgM antibodies to Mycobacterium leprae, one employing natural phenolic glycolipid and the other employing a synthetic disaccharide glycoconjugate as antigen. Estimates of sensitivity and specificity are derived, based on a panel of sera from leprosy cases in Malawi and various non-leprosy controls from the UK. Though both assays were able to identify a high proportion of multibacillary patients, neither was able to detect a high proportion of paucibacillary patients without considerable loss of specificity. The implications of the inverse relationship between sensitivity and specificity are discussed with reference to the predictive value of such tests in such areas as Malawi, where the large majority of cases are paucibacillary.

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Selected References

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  1. Bach M. A., Wallach D., Flageul B., Hoffenbach A., Cottenot F. Antibodies to phenolic glycolipid-1 and to whole Mycobacterium leprae in leprosy patients: evolution during therapy. Int J Lepr Other Mycobact Dis. 1986 Jun;54(2):256–267. [PubMed] [Google Scholar]
  2. Brett S. J., Draper P., Payne S. N., Rees R. J. Serological activity of a characteristic phenolic glycolipid from Mycobacterium leprae in sera from patients with leprosy and tuberculosis. Clin Exp Immunol. 1983 May;52(2):271–279. [PMC free article] [PubMed] [Google Scholar]
  3. Brett S. J., Payne S. N., Gigg J., Burgess P., Gigg R. Use of synthetic glycoconjugates containing the Mycobacterium leprae specific and immunodominant epitope of phenolic glycolipid I in the serology of leprosy. Clin Exp Immunol. 1986 Jun;64(3):476–483. [PMC free article] [PubMed] [Google Scholar]
  4. Cho S. N., Fujiwara T., Hunter S. W., Rea T. H., Gelber R. H., Brennan P. J. Use of an artificial antigen containing the 3,6-di-O-methyl-beta-D-glucopyranosyl epitope for the serodiagnosis of leprosy. J Infect Dis. 1984 Sep;150(3):311–322. doi: 10.1093/infdis/150.3.311. [DOI] [PubMed] [Google Scholar]
  5. Cho S. N., Hunter S. W., Gelber R. H., Rea T. H., Brennan P. J. Quantitation of the phenolic glycolipid of Mycobacterium leprae and relevance to glycolipid antigenemia in leprosy. J Infect Dis. 1986 Mar;153(3):560–569. doi: 10.1093/infdis/153.3.560. [DOI] [PubMed] [Google Scholar]
  6. Cho S. N., Yanagihara D. L., Hunter S. W., Gelber R. H., Brennan P. J. Serological specificity of phenolic glycolipid I from Mycobacterium leprae and use in serodiagnosis of leprosy. Infect Immun. 1983 Sep;41(3):1077–1083. doi: 10.1128/iai.41.3.1077-1083.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Copeland K. T., Checkoway H., McMichael A. J., Holbrook R. H. Bias due to misclassification in the estimation of relative risk. Am J Epidemiol. 1977 May;105(5):488–495. doi: 10.1093/oxfordjournals.aje.a112408. [DOI] [PubMed] [Google Scholar]
  8. Daniel T. M., Debanne S. M. The serodiagnosis of tuberculosis and other mycobacterial diseases by enzyme-linked immunosorbent assay. Am Rev Respir Dis. 1987 May;135(5):1137–1151. doi: 10.1164/arrd.1987.135.5.1137. [DOI] [PubMed] [Google Scholar]
  9. Douglas J. T., Celona R. V., Abalos R. M., Madarang M. G., Fajardo T. Serological reactivity and early detection of leprosy among contacts of lepromatous patients in Cebu, the Philippines. Int J Lepr Other Mycobact Dis. 1987 Dec;55(4):718–721. [PubMed] [Google Scholar]
  10. Fine P. E. Leprosy: the epidemiology of a slow bacterium. Epidemiol Rev. 1982;4:161–188. doi: 10.1093/oxfordjournals.epirev.a036245. [DOI] [PubMed] [Google Scholar]
  11. Izumi S., Sugiyama K., Fujiwara T., Hunter S. W., Brennan P. J. Isolation of the Mycobacterium leprae-specific glycolipid antigen, phenolic glycolipid-I, from formalin-fixed human lepromatous liver. J Clin Microbiol. 1985 Oct;22(4):680–682. doi: 10.1128/jcm.22.4.680-682.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kronvall G. The potential of immunological tests as tools in the epidemiology of leprosy. Lepr Rev. 1981 Dec;52 (Suppl 1):207–219. doi: 10.5935/0305-7518.19810071. [DOI] [PubMed] [Google Scholar]
  13. McDougall A. C., Ponnighaus J. M., Fine P. E. Histopathological examination of skin biopsies from an epidemiological study of leprosy in northern Malawi. Int J Lepr Other Mycobact Dis. 1987 Mar;55(1):88–98. [PubMed] [Google Scholar]
  14. Ponnighaus J. M., Fine P. E., Bliss L. Certainty levels in the diagnosis of leprosy. Int J Lepr Other Mycobact Dis. 1987 Sep;55(3):454–462. [PubMed] [Google Scholar]
  15. Ponninghaus J. M., Fine P. E., Bliss L., Sliney I. J., Bradley D. J., Rees R. J. The Lepra Evaluation Project (LEP), an epidemiological study of leprosy in Northern Malaŵi. I. Methods. Lepr Rev. 1987 Dec;58(4):359–375. doi: 10.5935/0305-7518.19870038. [DOI] [PubMed] [Google Scholar]

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