Authors:

Abstract

Background: Meningitis is a common infection of the brain and spinal cord which has significant short-term and long-term complications. Early diagnosis and treatment are essential to prevent these complications. For diagnosis of meningitis, cerebrospinal fluid (CSF) microscopy and biochemistry are required.

Objectives: To compare results of the urinary reagent strip method in estimation of CSF leucocytes, proteins and sugar with the standard method of CSF microscopy and biochemistry and to compare the utility of the reagent strip method for CSF analysis with the standard laboratory method for diagnosis of meningitis in the form of sensitivity, specificity, positive predictive value and negative predictive value.

Method: A prospective single-blinded study was conducted in the paediatric department of a tertiary care teaching hospital. We studied 111 consecutive CSF samples received in our laboratory within an hour of the tap. We recorded the age and sex of all samples. CSF samples were immediately processed for microscopy by an independent researcher. CSF proteins and glucose estimation were done in the biochemistry laboratory. The Combur-10 patch strip was used as an index test for CSF analysis (cells, proteins and glucose). Index tests and definitive tests were performed and diagnostic accuracy was compared between the two.

Results: This study was conducted on 111 consecutive CSF samples. Leucocyte positivity by test strip had a sensitivity of 100% and specificity of 99% for detection of CSF granulocytes of more than 15/ cu mm. For detection of CSF proteins greater than 30 mg/dL, the reagent strip method had a sensitivity of 97% and specificity of 89.7%. Specificity improved when we used a higher cut-off of CSF protein (greater than 100 mg/dL). Diagnostic accuracy of both leucocyte and protein strips was improved by using the higher cut off values. Glucose strips had a sensitivity of 82.9% and specificity of 89.7%.

Conclusions: Our study demonstrates that the urinary reagent strip method can be used for estimation of CSF leucocytes, proteins and sugar in resource-limited settings for early diagnosis and management of meningitis.

Sri Lanka Journal of Child Health, 2022; 51(2): 270-276

Keywords: Urinary reagent strip, CSF, Diagnostic, Meningitis