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PubMed1984

Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection.

The reliability of using urinalysis reagent strips, which semi-quantitatively measure hematuria and proteinuria, to correctly select urine specimens found by microscopy to have Schistosoma haematobium eggs was studied in 359 previously unscreened Kenyan primary school children. The presence of and degree of hematuria and proteinuria were highly correlated with the presence of S. haematobium eggs and with egg counts in urine specimens. Hematuria was more strongly correlated with S. haematobium egg counts than was proteinuria. The ability of presence of hematuria or proteinuria, or both, to select all microscopically positive cases of urinary schistosomiasis for treatment was tested using sensitivity (ST) and specificity (SP) analysis. Selection of cases using 1) presence of hematuria alone, and 2) presence of either hematuria or proteinuria had the highest combined ST and SP (88% ST, 97% SP; 91% ST, 92% SP, respectively). Most of the few cases detected by microscopy but not by reagent strips had low egg counts. The presence of hematuria alone failed to detect only 12% of S. haematobium-positive cases (mostly low egg counts), and only 3% of S. haematobium-negative persons had urinary blood and would have received unnecessary treatment. Preliminary studies on the use of reagent strips to screen previously infected children 6 months after treatment, and the effects of seasonal variations in temperature and humidity on urine specimen volume, egg counts, and reagent strip results are also presented. The practical field use and cost of reagent strips in S. haematobium control programs are discussed.

Adolescent↗

PubMed2005

Using reagent strips for rapid diagnosis of peritonitis in peritoneal dialysis patients.

Rapid diagnosis of peritonitis remains a significant goal in the management of patients who are maintained on peritoneal dialysis (PD). Several attempts to use leukocyte esterase reagent strips to diagnose peritonitis have been described. In the present study, we evaluated the usefulness of a new reagent strip, the PeriScreen Test Strip (Serim Research, Elkhart, IN, U.S.A.), for diagnosis of peritonitis in PD patients. This reagent strip for leukocyte esterase was designed to test PD fluid. It has 4 colorimetric grades (negative, trace, small, and large). We used the strips to evaluate PD fluid in 54 PD patients. In those patients, we diagnosed 19 episodes of peritonitis as defined by the criteria set out by the International Society for Peritoneal Dialysis. The test strips showed a sensitivity of 100%, a specificity of 97%, a positive predictive value of 95%, and a negative predictive value of 100%. PeriScreen Test Strip reagent strips have excellent utility as a simple, rapid bedside screening test to exclude peritonitis in PD patients.

Adult↗

PubMed1989

Eliminating unnecessary urine microscopy. Results and performance characteristics of an algorithm based on chemical reagent strip testing.

The ability of a urinalysis reagent strip to predict the presence of formed elements in the sediment was evaluated. The sensitivity of individual biochemical analytes varies from 0.51 to 0.85; however, the combined sensitivity of positive reactions for either protein, nitrite, leukocyte esterase, and/or hemoglobin is 0.95. Leukocyte esterase activity becomes detectable at a concentration of 15 white blood cells per high-power field (WBCs/HPF). Proteinuria is nonspecifically related to pyuria and detects a minimum concentration of 6 WBCs/HPF, and the hemoglobin reaction detects 6 red blood cells/HPF. Most false negative reactions are associated with bacteriuria. A positive chemical reagent strip test can be safely and effectively used as a prerequisite for routine urine microscopic examination.

Adolescent↗

PubMed1993

[Urinary specific gravity--comparative measurements using reagent strips and refractometer in 340 morning urine samples].

The specific gravity of urine (SG) indicates the number and weight of solute particles in urine; its measurement is helpful in interpreting proteinuria detected by dipstick tests and in monitoring adequate hydration in patients with nephrolithiasis. Four methods for measuring SG or osmolality of urine are currently available (depression of the freezing-point, urometry, refractometry, cation exchange on a reagent strip). Using a recently developed reagent strip, we have measured SG in morning urines of 340 non-selected outpatients and compared the results with SG measurements by refractometry of the same urines. In 86.2% of all urines, a good positive correlation between SG measured by reagent strip and refractometry was noted (r = 0.913, p = 0.0001). In 13.8% of the urines, however, the SG measured by reagent strip deviated by more than +/- 5 from the value obtained by refractometry; in 90% of these urines, glucosuria (reagent strip values too low or too high), proteinuria (values too high), or bacteriuria/leukocyturia (values too low or too high) could be found. In alkaline urine (pH > 7.0), SG values obtained by reagent strip have to be corrected by +5.

Female↗

PubMed2005

Use of reagent strips for the rapid diagnosis of spontaneous bacterial empyema.

GOALS: To assess the utility of reagent strips for rapid diagnosis of spontaneous bacterial empyema in cirrhotic patients with hepatic hydrothorax. BACKGROUND: Analysis of ascitic fluid using reagent strips is a useful diagnostic test for spontaneous bacterial peritonitis. METHODS: A reagent strip for leukocyte esterase designed for the testing of urine was used to evaluate pleural fluid analysis in 47 nonselected thoracenteses in 28 cirrhotic patients with hepatic hydrothorax. RESULTS: Twelve spontaneous bacterial empyemas were diagnosed. Simultaneous spontaneous bacterial peritonitis was present in 7 of 10 cases in which ascites fluid was analyzed. When a test result of 3 or 4 was considered positive, sensitivity was 83% (10 of 12), specificity was 100% (35 of 35), and positive predictive value was 100%. When result of 2 or more was considered positive, sensitivity was 92% (11 of 12), specificity was 80% (28 of 35), and negative predictive value was 97%. CONCLUSION: Analysis of pleural fluid with reagent strips is a rapid, easy to use, and inexpensive tool for the diagnosis of spontaneous bacterial empyema in cirrhotic patients. A positive result should be considered an indication for antibiotic therapy.

Bacteria↗

PubMed2002

Rapid diagnosis of inflammatory synovial fluid with reagent strips.

OBJECTIVE: To determine the usefulness of reagent test strips for screening inflammatory synovial fluid (SF). METHODS: Consecutive patients undergoing diagnostic arthrocentesis, attending the Department of Rheumatology of a large tertiary care hospital were evaluated. All SF specimens obtained were tested using two techniques: (i) white blood cell (WBC) count with the differential according to standard practice (which is considered the gold standard) (an inflammatory SF was defined as a WBC count > or =2000 cells/mm3); and (ii) reagent strips used to test urine (Multistix 8 SG, Bayer Diagnostics) for the presence of leucocytes (a positive test was defined as a strip showing more than a trace for leucocytes). Sensitivity, specificity, predictive values and likelihood ratio (LR) of the reagent strip in diagnosing inflammatory SF were determined. RESULTS: Two hundred and eight samples of SF were tested. The results of using the reagent strip were: sensitivity 76.9% (95% CI, 66.0-85.7%), specificity 86.9% (95% CI, 79.9-92.2%); positive LR, 5.88 (95% CI, 3.71-9.31) and negative LR, 0.27 (95% CI, 0.18-0.40). In 13 of the 19 false negative results, the differential cell count showed a predominance (> or =50%) of lymphocytes. CONCLUSION: This study suggests that, in daily practice, the evaluation of SF by reagent strips could be of use to discriminate between inflammatory and non-inflammatory SF.

Humans↗

PubMed1981

Adaptation of Prostatic-Group-Label Homogeneous Immunoassay to reagent-strip format.

The Prostatic-Group-Label Immunoassay (PGLIA) technique has been incorporated into a reagent-strip format. We report use of flavin N6-(N'-2,4-dinitrophenyl-6-aminohexyl)adenine dinucleotide (DNP-FAD) as the prosthetic group derivative and 6-N-(2,4-dinitrophenyl)aminohexanoic acid (DNP-caproate) as the competing ligand. DNP-FAD not bound by antibody combines with glucose oxidase apoenzyme, which then reacts with glucose and oxygen, and gives color through a peroxidase-linked system. The rate of color generation is thus a function of the DNP-caproate concentration. PGLIA reagent strips are prepared by sequential impregnations of filter paper with an acetone solution of indicator (3,3',5,5'-tetramethylbenzidine); an aqueous solution containing glucose oxidase apoenzyme, the rest of the color generation system, stabilizers, and antibody to DNP; and a solution of DNP-FAD in n-propanol. This preparation permits effective antibody binding, and prevents premature interaction of immunoassay components. A quantitative color response to concentrations of DNP-caproate in the range of 1 to 8 mumol/L was demonstrated with these reagent strips. Prototype PGLIA reagent strips for theophylline and phenytoin have been successfully developed by substituting the appropriate FAD derivative and antibody for the corresponding reagents in the DNP model system.

Aminocaproates↗

PubMed1990

Evaluation of the reagent strip test for haematuria in the control of Schistosoma haematobium infection in schoolchildren.

Several recent reports have indicated the potential of the reagent strip test for haematuria in the diagnosis of Schistosoma haematobium infection. Approximately 15,000 schoolchildren from a population of 40,000 people were examined for reagent strip microhaematuria on three occasions between 1986 and 1987 and treated with praziquantel 40 mg/kg if positive. The reagent strip was evaluated against a single filtration of 10 ml urine for S. haematobium eggs. Initially 65.9% of children were treated followed by 37.5% at the second examination 6 months later and 44.5% at the third examination a further 12 months later. Reagent strip sensitivity was shown to be related to the intensity of infection. The reagent strip specificity improved significantly with successive treatments indicating that haematuria was more sensitive than parasitology for light infections. The amount of S. haematobium reinfection was highest in the 7-9 year olds decreasing to the 16-20 year age group which suggested an impact of protective immunity. It was concluded that microhaematuria is a valuable indicator for the diagnosis of S. haematobium in national control programmes and can be substituted for parasitological examination with advantage but sensitivity and specificity should continue to be evaluated throughout the programme.

Adolescent↗

PubMed2002

Detecting bacteria in platelet concentrates by use of reagent strips.

BACKGROUND: Iatrogenic infection of immunosuppressed or immunocompromised hosts secondary to receipt of blood components containing bacteria may result in serious adverse outcomes. Measurement of pH and glucose by use of inexpensive reagent strips has been proposed as a practical means of screening for bacteria in platelet concentrate (PC) units. STUDY DESIGN AND METHODS: Glucose and pH were measured in 3093 PC units by use of reagent strips (Multistix, Bayer Corp.) to screen for bacterial content. Any PC classified by the reagent strip method as containing bacteria was subsequently cultured to confirm the presence and quantity of bacteria present. RESULTS: Thirty of 3093 PC units were classified as containing bacteria by the reagent strip method. Two of the 30 PC units positive by the reagent strip method were also positive by standard bacterial culture technique. Bacillus cereus was isolated from both units. CONCLUSION: Screening PC units by the reagent strip method resulted in 9.7 units per 1000 being wasted, but prevented two patients from receiving a PC unit containing B. cereus.

Bacillus cereus↗

PubMed1991

Semiquantitative determination of serum IgE by reagent strips: PRIST/TOTALE correlation.

Due to its great simplicity, the determination of total and specific IgE with a reagent strip could be a screening method for in vitro allergy diagnosis if a correlation with classical techniques is verified. The TOTALE reagent strip for semiquantitative determination of total serum IgE is one of these methods and unites the now classical foundation (anti-IgE/IgE/anti-IgE labeled sandwich) and the ease of the reagent strip technique. In a preliminary evaluation of these methods we compared the PRIST isotopic method to the TOTALE one for serum total IgE. In summary, the most relevant consequences from this comparison are the following ones: a) The initial sample is the same for both: serum. b) No additional equipment or materials other than the serum sample are needed for TOTALE practising. c) The reagent strip has a lower cost and is faster than the PRIST method. d) Correlation coefficients were 0.89 (n = 35) in the range of measurement under study and 0.93 (n = 23) in the range from 5 to 200 U/L.

Child↗

PubMed1994

The use of reagent strips for detection of urinary schistosomiasis infection in the middle Awash Valley, Ethiopia.

Reagent strip test was carried out to detect haematuria in urinary schistosomiasis infection in ten schools (1114 children) in the middle Awash Valley, Ethiopia. In five schools (557 children), were compared with results of urine filtration technique conducted simultaneously. The prevalence of infection by reagent sticks and urine filtration was 19.5% and 3.1%, respectively. Haematuria, detected by the reagent strip, was highly related with the results of urine filtration at the 2+ limit rather than the 1+ limit. However, the intensity of infection of all children was highly associated with prevalence rate at both haematuria limits. The possible use of reagent strips in Ethiopia to monitor morbidity (haematuria) due to S. haematobium infection is discussed.

Animals↗

PubMed1995

Reagent strip testing urine for significant bacteriuria in a urodynamic clinic.

OBJECTIVES: To determine the effectiveness of two reagent strips in detecting significant bacteriuria amongst patients attending for urodynamic assessment. PATIENTS AND METHODS: Four hundred patients undergoing urodynamic assessment were recruited for the study. Routine diagnostic catheter specimens of urine were tested for nitrite, leucocytes and protein. RESULTS: The leucocytes and nitrite strips had a high specificity rate of 99.5%. The frequency of significant bacteriuria in our population was 7% (n = 28). CONCLUSION: Culturing samples which test negative for these strips is unnecessary. Reagent strip testing of urine provides a cheap, rapid method of screening for infection.

Ambulatory Care↗

PubMed1990

[Evaluation of the detection of urinary tract infection by the reagent strip method in hospitalized patients].

Asymptomatic urinary tract infections (UTI) are frequent in hospital patients. Two prospective studies were carried out to evaluate the reagent strip method used to detect these infections. The diagnosis of UTI rested on cytobacteriological examination of urine. Detection by reagent strip was performed either in the microbiology laboratory (study 1: 976 samples) or at the patient's bedside and in the laboratory (Study 2: 225 samples). The strips were examined visually and by an automated device. There was no significant difference between the results obtained with these two reading methods. Study 1 showed that the reagent strip is more useful to exclude the diagnosis of UTI by using the leucocyte zone alone or combined with the nitrite zone (negative predictive value 98 percent) than to assert this diagnosis. Study 2 showed that the nitrite zone was less sensitive when it was examined at the laboratory than at the patient's bedside. Analysis of discordances between reagent strip and cytobacteriology in the light of data supplied by the patient's medical records made it possible to improve the negative predictive value of the tests. (100 percent). Thus, 60 percent of cytobacteriological examinations could be avoided if this type of examination was performed only in urine with positive leucocyte and nitrite zones. This means a 15 percent saving in B-coded examinations performed in hospital microbiology laboratories.

France↗

PubMed1999

Screening for urinary tract infections in a gynaecological setting: validity and cost-effectiveness of reagent strips.

This study aims to test the validity and cost-effectiveness of reagent-strip analysis compared with microbiological laboratory testing for mass screening of urine for urinary tract infections in a gynaecological setting. Over a six-month period, urine samples from a convenient group of 228 women presenting in a gynaecological ward of an NHS Trust hospital were tested using Ames 8SG reagent strips to detect leucocyte esterase and nitrite. Total bacterial counts were also carried out; urine culture was recorded as positive if there was > 10(5) organisms/mL. Validity of the dipstick tests was measured, using four criteria (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]), against the results of laboratory analysis. The combined use of the leucocyte esterase and nitrite tests produced results as follows: sensitivity, 96.4%; specificity, 88.5%; PPV, 54%; and NPV, 99.4%. Cost-effectiveness for visible costs was calculated as 48.6% for the 12.3% rate of infection in this study. The use of reagent strips in a mass-screening programme in a gynaecological setting proved both valid and cost-effective.

Cost-Benefit Analysis↗

PubMed2002

Reagent strip testing is not sensitive for the screening of asymptomatic bacteriuria in pregnant women.

The objective of the study was to assess the diagnostic performance of the reagent strip in screening for asymptomatic bacteriuria in pregnant women using urine culture as a gold standard. This study comprised 204 asymptomatic pregnant women who attended their first antenatal care at Srinagarind Hospital, Khon Kaen University from April 1, 1999 to June 30, 1999. Women with symptoms of urinary tract infection, antibiotic treatment within the previous 7 days, pregnancy-induced hypertension, bleeding per vagina and history of urinary tract diseases were excluded. Urine specimens were collected by clean catched midstream urine technique for urinalysis, reagent strip test and urine culture. Diagnostic performance of reagent strip in terms of sensitivity, specificity, positive and negative predictive value was analyzed. Urine reagent strip test had a sensitivity of 13.9 per cent, a specificity of 95.6 per cent, a positive predictive value of 46.1 per cent, a negative predictive value of 80.6 per cent in detecting asymptomatic bacteriuria in pregnant women.

Adult↗

PubMedDate not supplied

A comparison of reagent strips and the refractometer for measurement of urine specific gravity in hospitalized children.

Pediatric nurses in acute care settings routinely test urine for specific gravity, pH, glucose, protein, and other substances. In one tertiary care facility, nurses used the refractometer to test urine specific gravity and the reagent strip to test for other substances. This study was designed to provide data to determine if the reagent strip and the refractometer were interchangeable for measuring urine specific gravity in pediatric clients. Nurses obtained urine for specific gravity testing in 157 pediatric patients ranging in age from 1 day to 16 years. Each urine specimen was tested twice, once using the refractometer and once with the reagent strip. A Bland-Altman plot was used to determine the extent of agreement between the two measurement methods. The plot showed strong agreement between the two methods across a wide range of values for urine specific gravity. As a result of this study, staff nurses decided to use the reagent strip for urine specific gravity when other urine tests are needed and to use the refractometer when only a specific gravity is needed. This decision has resulted in a time savings for nurses who now do not have to repeat a reagent strip measurement. The decision also resulted in a savings of approximately $1200 in purchase of new refractometers for a newly constructed unit.

Adolescent↗

PubMed2000

The inaccuracy of venous and capillary blood glucose measurement using reagent strips in the newborn period and the effect of haematocrit.

The purpose of this study was to compare the accuracy of capillary and venous reagent strip tests (RST) against a reference plasma glucose method, and to assess the impact of haematocrit. One hundred and eighty infants admitted to the Neonatal Unit had blood glucose measured by reagent strip tests using capillary and venous blood samples. Venous plasma glucose was assayed by the Hexokinase method. Each infant had a venous haematocrit performed in the Neonatal Unit. Comparable inaccuracies were noted with both capillary and venous reagent strip tests at all levels. The mean difference between capillary RST and plasma glucose was 0.058 mmol/l (S.D. 1.39). The corresponding mean venous RST plasma glucose difference was 0.138 mmol/l (S.D. 0.96). The two means were statistically different from each other (P = 0.024), but this difference disappeared if the comparison was made only in babies with a PCV of 35-55%. At higher haematocrits (PCV >55%, N= 96) the mean difference between venous RST and plasma glucose was significantly more than the mean difference between capillary RST and plasma glucose (0.018 versus 0.295. P = 0.002). Hence the higher the haematocrit the more inaccurate the venous RST. This study confirms the limited value of reagent strip tests in the assessment of blood glucose in the neonatal period. It suggests that venous RST may be more inaccurate in comparison to capillary and that high haematocrits have a greater effect on venous RST than capillary RST.

Blood Chemical Analysis↗

PubMed1995

Comparison of urine filtration and a chemical reagent strip in the diagnosis of urinary schistosomiasis in Ethiopia.

The diagnostic efficacy of a chemical reagent strip (Ames Multistix) was compared with syringe-Nytrel urine filtration technique in the detection of S. haematobium infection at varying disease endemicity levels in the Awash Valley of Ethiopia. In low endemicity area (Afambo), the reagent strip showed highest sensitivity, specificity, positive predictive value and negative predictive value of 80%, 96%, 40% and 99% respectively at "1+ limit" of microhaematuria. In the moderate (Dahitele) to high (Enta Doyta) areas, the highest diagnostic values of 77%, 83%, 56% and 93% respectively and 78%, 67%, 51% and 87% respectively were obtained at "trace limit". Using these cut-off points of haematuria, the prevalence of S. haematobium were 4.5%, 30.8% and 47% at low, moderate and high endemicity areas compared to 3.2%, 21% and 31% respectively using the filtration technique. A highly significant (maximum Kendall's tau = 0.44271; p < 0.002) was observed between N + 1 transformed geometric mean egg counts and micro-haematuria in the 10-19 years of age at all levels of endemicity. The efficacy and simplicity of chemical reagent strips and limitations of single parasitological examinations are discussed.

Adolescent↗