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Scrub Typhus Serologic Testing With The Indirect Immunofluorescence Method As A Diagnostic Gold Standard: A Lack Of Consensus Leads To A Lot Of Confusion, Stuart Blacksell, Naomi Bryant, Daniel Paris, Jenny Doust, Yoshihiro Sakoda, Nicholas Day

Jenny Doust

A review was performed to determine the evidence base for scrub typhus indirect immunofluorescence assay (IFA) methodologies and the criteria for positive results. This review included a total of 109 publications, which comprised 123 eligible studies for analysis (14 publications included 2 substudies). There was considerable underreporting of the IFA methodology and seropositivity criteria used, with most studies using a defined cutoff titer rather than an increase in the titer in paired samples. The choice of positivity cutoff titer varied by country and purpose of the IFA test. This variation limits the comparability of seroprevalence rates between studies and, more …