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Serological Test

Serological test results vary heavily depending on immunity response at the time test is performed and the length of disorder.

Serological test done to detect of dengue fever utilizes serum in its process. Dengue fever is the first infection have both classification of primary and secondary infections. Primary infection called Dengue Fever, and secondary infection known as Dengue Haemorragic Fever (DHF). The infection could progress to shock and lead to death. For dengue fever, available serological examinations are NS-1 antigen test, and dengue IgG & IgM antibodies.

  • NS-1 antigen test could be performed day 1 to day 9 of both primary and secondary infections. This test is an early inspection test to detect the virus.
  • In primary infection, IgM antibodies can be found after day 4-5 of the fever, where IgG antibodies arise after day 14 of the fever and will stay present for a long term. In secondary infection, IgG antibodies will be produced first, 1-2 days after symptoms of the fever arise, where IgM antibodies are present after 5-10 days of the fever.

Antibody tests for Chikungunya IgM virus is performed in fever patients with symptoms of dizziness, headache, joint pain, and red rash on the skin. The test for Chikungunya IgM virus confirms these symptoms. If results turn out negative, it is recommended to get re-tested 2-4 days after.

Widal test is a test to detect typhoid fever that is infected by Salmonella typhi or Salmonella paratyphi A, B, C. Widal test is not specific as results often displays cross-reaction between bacteria found in the intestine. To detect specific infection such Salmonella typhi, Salmonella typhi IgM test is a more suitable option.

Gastric infections caused by the bacteria Helicobacter pylori can lead to inflammation, peptic ulcers, and malignancy. Helicobacter pylori can be detected by checking for antibodies called H.pylori IgG-IgM.

Many other infectious diseases in Indonesia are infections from parasite Entamoeba histolytica that can cause intestinal bleeding leading to damage/perforation of intestinal wall. Patients suspecting this infection from this parasite could undergo antibody IgG test for tuberculosis germs.

Particular Tuberculosis (TBC) cases where bacteria has spread throughout the body can be detected by specific antibody test for tuberculosis germs.

Syphilis caused by Treponema pallidum can be detected by VDRL/TPHA examinations. VDRL is not a specific test for syphilis, but is sufficiently sensitive to the disease. VDRL test could show false positive results in some cases such TBC, leprosy and yaws, and false negative results for early stages  and advance stages of Syphilis. To confirm presence of Treponema pallidum, serological TPHA test is recommended to examines specific antibodies for Treponema pallidum.

Chlamydia trachomatis is an intracellular gram-negative bacteria. Infection by this bacteria can cause non-gonorrheal urethritis, lymphogranuloma venereum, trachona, neonatal pneumonia, and Reifer’s syndrome. Most diseases caused by this bacteria are non-gonorrheal urethritis. 40% of non-gonorrheal urethritis cases are cause by Chlamydia bacterial infection, where 70% in women lead to endocervical infection and 50% in men leads to asymptomatic urethritis. Bacterial infection with C. trachomatis can be confirmed by detecting C.trachomatis antibodies or antigens. Antibody test for C.trachomatis uses serum or plasma. This antibody test is classified into 2; IgG and IgM. IgM antibody test, however, is not always reliable as IgM does not always present in acute infections. The same case happens with IgG. False positive results often occur with IgG antibodies in cases of rheumatoid factors in the blood that interferes with the reaction during examination process.

Measles is a highly contagious disease in children caused by measles virus. The disease is known for its symptoms of inflammation of the mucous membrane in the upper respiratory tract, accompanied by skin rash. The disease also comes with pneumonia, complications in the ears and brain. Hearing loss is a possible outcome and in pregnant women, Measles virus can cause spontaneous abortion, fetal death, and congenital defects. Diagnosis can be confirmed by physical examination and antibody IgM test for Measles virus in serum in acute conditions. Antibody IgG test is also recommended short after recovery, as these antibodies can be persistent or due to vaccination.

Acute Mumps virus infection can cause inflammation of the salivary glands (parotitis), inflammation of the lining of the brain (meningitis), and inflammation of the testicles (orchitis). Antibody IgM test for Mumps virus can confirm the infection, with IgG antibody test to outline past infections. IgG antibodies for Mumps virus may be obtained after 12-24 months from immunization.