Multisite Validation of Cryptococcal Antigen Lateral Flow Assay and Quantification by Laser Thermal Contrast

• DOI: 10.3201/eid2001.130906
• Publication Date: 2013-12-02T13:49:12Z
• Authors: David R. Boulware; Melissa A. Rolfes; Radha Rajasingham; Maximilian von Ho...; Zhenpeng Qin; Kabanda Taseera; Charlotte Schutz; Richard Kwizera; Elissa K. Butler; Graeme Meintjes; Conrad Muzoora; John C. Bischof; David B. Meya
• Keywords: Latex fixation test; Cryptococcal meningitis; Serial dilution

Abstract Cryptococcal meningitis is common in sub-Saharan Africa. Given the need for data a rapid, point-of-care cryptococcal antigen (CRAG) lateral flow immunochromatographic assay (LFA), we assessed diagnostic performance of cerebrospinal fluid (CSF) culture, CRAG latex agglutination, India ink microscopy, and LFA 832 HIV-infected persons with suspected during 2006–2009 (n = 299) Uganda 2010–2012 533) South had best (sensitivity 99.3%, specificity 99.1%). Culture sensitivity was dependent on CSF volume (82.4% 10 μL, 94.2% 100 μL). agglutination test (97.0%–97.8%) (85.9%–100%) varied between manufacturers. microscopy 86% sensitive. Laser thermal contrast 92% accuracy (R 0.91, p<0.001) quantifying titers from 1 strip to within <1.5 dilutions actual titers. major advance diagnostics resource-limited settings.