Abstract
Background: Inflammatory diarrhoea (ID) resulting from Shigella, Salmonella, Campylobacter and Entamoeba histoly-tica requires specific diagnosis for therapy. Differentiation between ID and non-inflammatory diarrhoea (NID) is often not clinically possible. A faecal occult blood test (FOBT) correlates with faecal leucocytes. Lactoferrin indicates an inflammatory process as a marker for faecal leucocytes. We evaluated diagnostic values of lactoferrin latex aggluti- nation test (LT) either alone or in combination with FOBT, correlating with stool microscopy and microbiology in differentiating ID from NID. Methods: The study population constituted patients enrolled in 2% systematic sampling of patients under Diarrhoeal Disease Surveillance System of Dhaka Hospital, ICDDR,B. Results: Between July and November 2002, 594 patients were enrolled; evaluation of FOBT and LT were done in 448/594 (75%) patients from whom either a single enteropathogen (315/594, 53%) or no pathogen (133/594, 22%) were identified and 146 were excluded for multiple pathogens. Invasive and non-invasive pathogens were isolated from 24% and 76% of the patients. FOBT and LT were positive in 40% and 39% of the samples. The sensitivities, specificities, PPVs, NPVs, and accuracies of FOBT were 55, 63, 24, 87 and 62%, and LT were 52, 64, 23, 86 and 62%, respectively. Conclusion: FOBT and LT are not useful in differentiating ID from NID in diarrhoeal patients in Dhaka, Bangladesh.
Journal Section:
Original Paper
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