Date of Award

Summer 8-7-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Matthew Hayat, PhD

Second Advisor

Ruiyan Luo, PhD

Third Advisor

Melissa Coughlin, PhD

Fourth Advisor

Bettina Bankamp, PhD

Abstract

INTRODUCTION: Measles and rubella are highly contagious viral diseases. Measles remains one of the leading causes of vaccine-preventable deaths, and rubella during pregnancy can cause congenital rubella syndrome. The enzyme immunoassay (EIA) is most frequently used to determine antibody responses to measles and rubella, and the plaque reduction neutralization assay (PRN) is considered the gold standard for determining measles immunity. A measles and rubella multiplex bead assay (MBA) is currently being evaluated at the Centers for Disease Control and Prevention for its utility in serosurveillance within the World Health Organization Global Measles and Rubella Laboratory Network, and the MBA has several benefits over these assays. The MBA requires a smaller sample volume, measures several diseases simultaneously, is faster, and has less technician-dependency than the PRN.

AIM: Study objectives are to compare accuracy of measles serological status from both the MBA and EIA when compared with the PRN, and to evaluate whether country or participant age are associated with test accuracy.

METHODS: Samples for participants of varying ages from the United States, Tajikistan, and Bangladesh (n=300) that had been tested by each assay were used. Results were dichotomized as positive or negative according to respective assay cutoff values. Logistic regression models were applied to estimate point estimates and confidence intervals for sensitivity and specificity of the MBA and EIA with relation to the PRN gold standard.

RESULTS: Across the three age groups and countries, EIA has higher median values (mIU/ml) compared with MBA and PRN (582.55, 399.28, and 378.95, respectively, for Tajikistan participants aged 13 and older). McNemar’s Test of Agreement comparing MBA and PRN suggests disagreement (p

DISCUSSION: When compared with the PRN, the MBA has similar accuracy to the EIA with regards to sensitivity and specificity, and in several groupings of country and age, these percentages are higher for the MBA. Many of the benefits of the MBA over conventional assays have led to its increased application in research, and these results suggest the MBA can be used in settings where the EIA is currently used.

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