Table 3.

References tests used in studies evaluating Leptospira biflexa serovar Patoc lateral flow IgM assays for the diagnosis of leptospirosis, published prior to 4 July 2017

Study first author, number (reference)	Reference test	Number of Leptospira serovars in reference test	Participants with reference test performed on paired serum samples	Reference test leptospirosis case definition
Smits 1a (12)	MAT	1	100%	≥ four-fold rise in MAT titre or single MAT titre ≥160
Smits 2a (12)	ELISA	Not stated	0%	Single antibody titre ≥80
Eapen (17)	ELISA	2b	0%	Single antibody titre ≥80
Sehgal (13)	MAT + culture	12	89%	Positive culture, or seroconversion to an MAT titre ≥100, or a four-fold rise in MAT titre, or a single MAT titre≥400
Kannan (10)	MAT	Not stated	0%	Single MAT titre≥100
Limmathurotsakul (21)	MAT + culture	20	66%	Positive culture or single MAT titre ≥400
Goris 1a (14)	MAT + IgM ELISA + culture	14b	Not statedc	(i) Single MAT titre with a pathogenic serovar ≥160, (ii) single IgM-ELISA titre ≥160, (iii) positive culture or (iv) seroconversion/four-fold titre rise MAT or IgM ELISA (titre ≤20 to ≥80) in paired samples taken at least 2 days apart
Goris 2a (14)	MAT + IgM ELISA + culture	14b	Not statedc	(i) Single MAT titre with a pathogenic serovar ≥160, (ii) single IgM-ELISA titre ≥160, (iii) positive culture or (iv) seroconversion/four-fold titre rise MAT or IgM ELISA (titre ≤20 to ≥80) in paired samples taken at least 2 days apart
Niloofa (15)	MAT	13	28%	Single Mat titre ≥400
Podgorsek (16)	MAT	1b	6%	Seroconversion to an MAT titre ≥100, or a four-fold rise in MAT titre, or a single MAT titre≥400
Eugene (18)	MAT + culture	1b	0%	Positive culture or single MAT titre ≥100

Footnote:

^aNumbers refer to different datasets from within the same paper;

^bSerovars included Leptospira biflexa serovar Patoc;

^cFigures not stated but paper states that ‘In most cases only one sample was received per participant’;

MAT = Leptospira microscopic agglutination test; IgM ELISA= Immunoglobulin M enzyme-linked immunosorbent assay