Standard definition of a clinical case of mumps and diagnostic effectiveness of the test systems used in the modern period

Abstract

Introduction. Registration of regular epidemic outbreaks of mumps infection among young people, difficulties in the clinical diagnosis of the disease, the presence of specific clinical manifestations in adults with a severe course of infection make it necessary the improvement of the quality of diagnosis of the disease. The aim of the work is to develop a standard definition of a clinical case of mumps and to conduct a comparative assessment of the effectiveness of the diagnostic test systems used for mumps diagnostics based on the determination of their sensitivity and specificity. Materials and methods. To develop a standard definition of a clinical case of mumps based on ten combined clinical and laboratory parameters, a mathematical model was built using the logistic regression method. The study included 84 patients with mumps infection (main group) and 66 patients with non-epidemic sialoadenitis (comparison group). For a comparative evaluation of the diagnostic systems VectoParotitis-IgM, VectoParotitis-IgG, ELISA-Mumps-IgM, ELISA-Mumps-IgG, Anti-Mumps Virus ELISA-IgM, and Anti-Mumps Virus ELISA-IgG, a blood serum samples from patients (n = 41) with a diagnosis mumps? were tested in dynamics to assess their sensitivity, specificity, and diagnostic effectiveness. Results. The clinical symptom dry mouth increased the chance of diagnosing mumps by 13.7 times, the presence of bilateral lesions of the salivary glands by 6.5 times, the increase in the level of diastase in the urine by 3.2 times. The coefficient of determination R2 was 61.1; the sensitivity was 93% and the specificity 67%; p 0.001. Diagnostic effectiveness of Anti-Mumps Virus ELISA-IgG test system was 84.4%, ELISA-Mumps-IgG 87.2%, and "VectoParotitis-IgG" 88.5%. Conclusions. Based on the combination of following clinical symptoms observed simultaneously in patient, of the general weakness, dry mouth, bilateral lesions of the salivary glands, an increase in the level of diastase in the urine, it is possible to establish a clinical diagnosis of mumps with a probability of 81%. The highest diagnostic effectiveness of domestically manufactured test systems for quantitation of IgG antibodies to mumps virus in sick people has been demonstrted.

Keywords

• mumps
• standard definition of a clinical case
• enzyme immunoassay
• mathematical model