Use of urine reagent strip to evaluate CSF for bedside diagnosis of pyogenic meningitis in paediatric age group: A Hospital Based observational study

Abstract

Background: Cerebrospinal fluid (CSF) analysis is required to make a diagnosis of meningitis to aid in the proper management of patients. In urban areas with good health-care facilities, it is easy to get a CSF analysis done. However, in rural and remote areas with no proper transport facilities, such a simple point of care test will definitely be useful. We conducted a study and compared the results of reagent strip test with the biochemical tests and microscopic examination. Aims and Objectives: The aim of the study was to determine the utility and efficacy of reagent strip test on CSF .Materials and Methods: A prospective, time-bound study was carried out department of pediatrics Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India on the CSF sample remaining after the biochemical tests and microscopic examination. The values of both the methods were compared. Using Chi-square and Fischer’s exact test, data were analysed.                                     

Results: Leukocyte esterase positivity by test strip had a sensitivity of 84.6% and specificity of 51.9% , Positive predictive value=25.6%, Negative predictive value= 94.5% for detection  of CSF granulocytes more than 10 cells/mm³ . The association of CSF cell count at cut off more than 10 cells/ul was found to statistically significant with presence of bacterial meningitis (p-value =0.005). The sensitivity of glucose strip with trace reading in detection of bacterial meningitis was found to be 92.3%, specificity was 56.4%, positive predictive value was 29.3% and negative predictive value was 97.4%

Conclusion: This test will be useful in remote areas as a point of care test for early patient management.