Immunochromatographic test for rapid serological diagnosis of human angiostrongyliasis

Objectives: The serological diagnosis of human infection with Angiostrongylus cantonensis remains problematic because there are no commercially available validated tests. Most laboratories use domestically prepared tests such as the enzyme-linked immunosorbent assay (ELISA) or immunoblotting. Since laboratory facilities are not always available in endemic areas, we developed and assessed a rapid lateral flow immunochromatographic assay (AcQuick(Dx) Test) to detect anti-A. cantonensis antibodies in human serum. Methods: The test device was assembled with purified 31-kDa glycoprotein as diagnostic antigen and with gold-labelled anti-human immunoglublin-G as the detector reagent. A total of 97 serum samples were tested - 19 samples from clinically diagnosed patients with detectable A. cantonensis-specific antibody in immunoblotting; 43 samples from patients with other parasitic diseases, i.e. gnathostomiasis (n=13), toxocariasis (n = 2), trichinellosis (n = 2), hookworm infection (n = 4), filariasis (n = 5), cysticercosis (n = 9), paragonimiasis (n = 2), opisthorchiasis (n = 3), and malaria (n = 3); and 35 samples from normal healthy subjects. Results: The sensitivity, specificity, positive predictive value and negative predictive value of AcQuick(Dx) Test to detect anti-A. cantonensis specific antibodies in serologically confirmed angiostrongyliasis cases, were 100%, 98.72%, 95% and 100%, respectively. Positive AcQuick(Dx) was observed in 1 of 4 cases with hookworm infections. No positive AcQuick(Dx) was observed incases with other parasitic diseases, and the individual healthy subjects. Conclusions: AcQuick(Dx) Test is rapid, highly sensitive and specific, and easy to perform without additional equipment or ancillary supplies. It yields results that are interpreted visually, and possesses a long shelf-life at room temperature. Thus, it can be applied as an additional test for clinical diagnostic support of angiostrongyliasis either in conventional laboratories or for remote areas where laboratory infrastructure is not available. (C) 2018 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4 .0/).