# Evaluation of a point-of-care immunochromatographic assay for enteric fever

> **NIH NIH R21** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $291,463

## Abstract

PROJECT SUMMARY
Enteric fever, an invasive bacterial infection caused by Salmonella enterica serotypes Typhi and
Paratyphi A, B, and C, remains a major cause of illness and death globally. Timely diagnosis
and treatment are critical to reducing morbidity and risk of serious complications from enteric
fever. However, there are currently no diagnostics with sufficient accuracy and speed for guiding
treatment decisions. Rapid serologic diagnostics have low predictive value, particularly in
typhoid-endemic settings. Blood culture has high specificity, but sensitivity is estimated at 60%,
and results take 2-4 days to become available. Through high-throughput immunoscreens, we
found that IgA antibodies to hemolysin E (HlyE) and S. Typhi lipopolysaccharide (LPS) are
robust markers of acute enteric fever, reliably distinguishing patients with enteric fever from
those with other acute infections in Nepal and Bangladesh (AUC 0.95). We have further
developed a point-of-care immunochromatographic assay, using Chembio's dual path platform
(DPP®) technology, to quantify anti-HlyE and anti-LPS IgA responses. Our preliminary data
demonstrated excellent concordance with ELISA and high accuracy in distinguishing enteric
fever cases from controls. We now propose to: 1) evaluate the accuracy of the DPP Typhoid
assay using biobanked plasma from patients with enteric fever and a diverse array of other
febrile illnesses collected from multi-country surveillance studies in South Asia and sub-Saharan
Africa; and 2) prospectively evaluate the DPP Typhoid assay with fingerstick capillary blood
among individuals with acute febrile illness in a typhoid-endemic setting. These studies will
leverage diverse, globally representative enteric fever surveillance platforms, investigate
alternative etiologies of febrile illness, and rigorously test the novel assay performance in direct
comparison with existing enteric fever diagnostics. Successful completion of this project would
fill a major gap in diagnostics for enteric fever which could improve clinical management, reduce
overdiagnosis and unnecessary antibiotic use, and facilitate enteric fever control initiatives.

## Key facts

- **NIH application ID:** 10234850
- **Project number:** 1R21AI161770-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Jason Randolph Andrews
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $291,463
- **Award type:** 1
- **Project period:** 2021-04-13 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10234850

## Citation

> US National Institutes of Health, RePORTER application 10234850, Evaluation of a point-of-care immunochromatographic assay for enteric fever (1R21AI161770-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10234850. Licensed CC0.

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