Assessment of measles diagnostic from gingival fluid in Côte d'Ivoire

After the adoption of the Global Initiative for Measles Elimination in 2001, Côte d'Ivoire has created monitoring case by case. Thus, the diagnosis of measles from the gingival fluid was implemented, through a pilot project. This study aimed to evaluate the performance of this diagnostic test. We conducted a cross-sectional survey, in four health districts of Abidjan, during a period from July 2010 to December 2012. The study consisted in collecting gingival fluid and serum samples in all suspected measles children. These samples were analyzed by ELISA test at Pasteur Institute of Côte d'Ivoire. Standard formulas were used to calculate sensitivity, specificity, positive predictive value and negative predictive value of oral fluid compared to serum taken as the "gold standard" and confidence intervals were estimated with error alpha risk (α =0.05). The concordance of kappa coefficient (k) was used to estimate agreement level between the results of oral fluid analysis and those of serum. The sensitivity and specificity of the test were 98% and 82% respectively while the positive predictive value and the negative predictive value were 84% and 98%. The comparison of oral fluid with the reference test showed high agreement, between 0.61 and 0.80. The diagnostic test on gingival fluid is acceptable because its sensitivity, specificity and negative predictive value had high level. Therefore it can be extended to all sanitary districts.