Leukocyte esterase reagent strips: rapid, economical and reliable cow side test for subclinical endometritis


Abstract: This study was carried out in crossbred cows (>60 DIM) to evaluate leukocyte esterase (LE) strip test, protein strip test, pH strip test, white side test (WST) of estrual mucus, in comparison to endometrial cytology (EC) using cytobrush (CB) as reference diagnostic method for subclinical endometritis (SCE). Endometrial cytology was done in 78 cows with ≥4% PMNs as cut-off value for SCE. Leukocyte esterase strip test was done by contacting estrual mucus with multireagent urinalysis reagent strips and results recorded after 10 min. Similarly, protein and pH strip tests were conducted using the same strips and results recorded after 60 s. White side test of estrual mucus was conducted simultaneously. Leukocyte esterase, protein and pH strip tests were evaluated and analyzed statistically using receiver operator characteristic (ROC). LE strip test at cut-off value ≥ ± acquired from ROC analysis showed sensitivity (Se) of 86.67% and specificity (Sp) of 66.67%. Similarly, protein and pH strip tests showed Se of 53.33%, 66.67% and Sp of 66.67%, 77.78%, respectively. Strip tests were also combined in three combinations (LE + protein, LE + pH and LE + protein + pH) and overall decrease in Se was observed in all three combinations (46.67%, 60% and 33.33%, respectively); while, a slight increase in Sp (77.78%) was also observed. Sensitivity and Sp of WST were 63.33% and 55.56%; respectively, and these values for WST were lower compared to those in LE test. In conclusion, cow side LE test can be used as an economic and easy test with acceptable Se and Sp compared to WST instead of EC for SCE in cattle. However, no improvement in performance of LE strip test was observed when combined with pH and protein strip tests.

Keywords: Subclinical endometritis, endometrial cytology, leukocyte esterase strip test

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