The Accuracy of Elisa Versus Latex Agglutination Tests in Diagnosis of Rotavirus Acute Gastroenteritis and the Clinical Usefulness of C- Reactive Protein in Iraqi Children

Ali Ibrahim Ali Al-Ezzy


AIM: The aim is to evaluate the accuracy of ELISA versus Latex agglutination tests in the diagnosis of rotavirus. Evaluate the usefulness of C-reactive protein (CRP) level in rotavirus diagnosis and the possible effect of age and gender in CRP level.

METHODS: Detection of viral antigen in faecal samples via ELISA and Latex agglutination tests. CRP detected in (80) children serum samples.

RESULTS: The range of CRP level was (6-96 mg/dl). ELISA more Sensitive (84.62%) than latex agglutination (61.11%) in the diagnosis of rotavirus, although the specificity of latex agglutination was 90.91% versus (74.07 %) in ELISA. Both tests give identical accuracy (77.5%) in the detection of rotavirus. Moderate agreement reported between ELISA and latex agglutination in the diagnosis of rotavirus (kappa value = 0.534). A significant difference and inverse correlation between male; female and CRP level were detected. Age significantly correlated with latex agglutination results (p = 0.013). CRP level inversely correlated with latex agglutination and ELISA results (p = 0.000). ELISA results inversely correlated with latex agglutination (p = 0.000).

CONCLUSIONS: Although ELISA appears to be more sensitive in rotavirus diagnosis, latex agglutination has the same accuracy and can be used in an emergency (take into consideration the false positive results) as an alternative method for rotavirus diagnosis. Latex agglutination results affected by age which is an important drawback. CRP level inversely correlated with gender, latex agglutination and ELISA results.


Rotavirus; ELISA Latex agglutination; accuracy age; gender; CRP

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Elhag W, Saeed H, El Fadhil EO, Ali A. Prevalence of rotavirus and adenovirus associated with diarrhea among displaced communities in Khartoum, Sudan. BMC infectious diseases. 2013; 13(1):209. PMid:23657114 PMCid:PMC3655852

Elawad M, Masaad T. Epidemiology of Rotavirus Infection in Children Less than Five Years in Omdurman Paediatric Hospital, Khartoum, Sudan. International Journal of Biomedical Research. 2015; 6(3):219-222.

Khatib PK, Khan ZH. Biochemical studies in serum of children suffering from rotavirus diarrhoea. Bioscience Discovery. 2012;3:25-29.

Sai L, Sun J, Shao L, Chen S, Liu H, Ma L. Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji'nan, China Virol J. 2013;10:302. PMid:24099150 PMCid:PMC3851746

Magzoub MA, Bilal NE, Bilal JA, Osman OF. Rotavirus infection among Sudanese children younger than 5 years of age: a cross sectional hospital-based study. Pan African Medical Journal. 2014;16(1).

Nunes A, Mello L, Parrode R, Bittar J. Prevalence of rotavirus in feces of children with acute diarrhea: clinical signs and associated symptoms. Revista da AMRIGS. 2010;54(2):147-151.

Enweronu-Laryea CC, Sagoe KW, Glover-Addy H, Asmah RH, Mingle JA, Armah GE. Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age. The Journal of Infection in Developing Countries. 2011;6(02):148-155.

Pirkooh AA, Shahrabadi MS. Development of a latex agglutination method for diagnosis of rotavirus infections. Iranian Journal of Medical Sciences. 2015;32(2):100-104.

Biokit: Rotagen: Latex agglutination test on slide for the qualitative determination of Rotavirus antigen in stool. Avaibable from:

Epitopediagnostics: Fecal Rotavirus Antigen ELISA Kit. Avaibable from:

SPINREACT: Qualitative determination of C-Reactive Protein (CRP), CRP-Latex Slide agglutination. Avaibable from:

Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360-363. PMid:15883903

Abood WN. Performance Of Enzyme Linked Immunosorbent Assay Versus Latex Agglutination Test In The Diagnosis Of Acute Gastroenteritis By Rota Virus. Journal of Al-Nahrain University. 2010; 13:107-111.

Dhiman S, Devi B, Singh K, Devi P. Comparison of Enzyme-Linked Immunosorbent Assay and Immunochromatography for Rotavirus Detection in Children Below Five Years with Acute Gastroenteritis. 2015.

Lee W-T, Lin P-C, Lin L-Cn, Chen H-L, Yang R-C. Salmonella/rotavirus coinfection in hospitalized children. The Kaohsiung journal of medical sciences. 2012;28(11):595-600. PMid:23140767

Zaman NA-K, Al-Tae A-RA, Saadoon IH. Rotavirus, Enteropathogenic Escherichia coli (EPEC) and Parasitic Etiology of Pediatric Diarrhea in Kirkuk city. In: Second Scientific Conference – Science College – Tikrit University Iraq, 2012: 121-124.

Ahmed HM CJ, Nakagomi O, Hart CA, Zaki JM, Al-Rabaty AA, et al. Molecular characterization of rotavirus gastroenteritis strains, Iraqi Kurdistan. Emerg Infect Dis. 2006;12(5):824-826. PMid:16704845 PMCid:PMC3374452

AL-Ezzy AIA, Abood WN. Immuno-Microbiological Diagnosis of Co-Infections with Rota Virus, Giardia lamblia, Entamoeba histolytica And Salmonella enterica As A Possible Pathological Strategy For Acute Diarrhea Among Iraqi Children. International Journal of Advanced Research. 2013;1:216-224.

Khoury H, Ogilvie I, El Khoury AC, Duan Y, Goetghebeur MM. Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population. BMC infectious diseases. 2011; 11(1):9. PMid:21214934 PMCid:PMC3022719

Mustafa NS, Elhag WI. JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES. sciences (J Pharm Biomed Sci). 2013; 33(33):1594-1598.

Kheyami AM, Cunliffe NA, Hart CA. Rotavirus infection in Saudi Arabia. Annals of Saudi medicine. 2006; 26(3):184. PMid:16861867

Emamghorashi F, Rajabi S, Shadman A. Frequency of Rotavirus infection in children with acute gastroenteritis in Jahrom, South of Iran. Iranian Journal of Medical Sciences. 2008;33(2):84-87.

Khuri-Bulos N, Al Khatib M. Importance of rotavirus as a cause of gastroenteritis in Jordan: a hospital based study. Scandinavian journal of infectious diseases. 2006;38(8):639-644. PMid:16857608

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