Evaluation of serodiagnostic tests for visceral larva migrans

Abstract

Four serologic techniques for the diagnosis of visceral larva migrans caused by Toxocara canis, namely indirect hemagglutination (IHA), bentonite flocculation (BF), enzyme-linked immunosorbent assay (ELISA), and double diffusion in agar (Ouchterlony), were evaluated using sera sent to the Center for Disease Control from patients with a presumptive diagnosis of visceral larva migrans (VLM). Patients having 5-6 of the clinical or laboratory criteria for VLM were designated as cases while those with 0-2 criteria served as controls. The sensitivity of the ELISA was 78.3% compared to 18.2%, 25.8% and 65.2% for the IHA, BF, and Ouchterlony, respectively; the sepcificity of all four tests was greater than 92%. The predivtive value of positive test was greater than 85% for all tests except the IHA, while the predictive value of a negative test was greater than 85% only for the ELISA. The results of a ELISA were reproducible in different laboratories. Based on these findings, the ELISA using a larval antigen appears to be the serodiagnostic method of choice for VLM.