An evaluation of 1,838 stored sera from seven countries found that a second-generation Hcp1 antibody test had sensitivity ranging from 48% to 92%, with specificity varying by country and comparison group.
Key findings
- Country-specific sensitivity was 92%, 77%, 76%, 80%, 74%, 90% and 48%. Specificity among healthy controls was 96%, 79%, 98%, 100%, 100%, 87% and 100%, and among other-infection controls 97%, 87%, 98%, 98%, 100%, 90% and 94%.
Why this matters globally
The multicountry evidence shows that serological performance cannot be assumed transferable across settings because background exposure, testing time and patient spectrum differ.
Thai researcher contribution
Thai researchers from Mahidol University and MORU contributed to an international network seeking better diagnostics for a major tropical disease.
Limitations to consider
Stored retrospective specimens and a case-control structure create spectrum bias and do not reproduce a real diagnostic pathway. Antibodies may reflect prior exposure, and performance varied substantially by setting.