Comparative Assessment of Rapid Antigen Test Kits for Forensic Detection of Narcotic Substances in Blood and Urine Samples
DOI:
https://doi.org/10.61561/ssbgjms.v7i03.162Keywords:
Rapid antigen test, Narcotic substances, Forensic toxicology and Confirmatory testingAbstract
Background: Illicit narcotic substance use is an important public health and medico-legal problem, requiring reliable detection in biological samples during forensic investigations. Rapid antigen test kits are simple, quick, and practical for preliminary screening, particularly in resource-limited settings, but their performance may vary between blood and urine samples.
Objective: This study aimed to compare the detection pattern and diagnostic performance of rapid antigen test kits for narcotic substances in blood and urine samples among suspected narcotic exposure cases.
Methods: This comparative cross-sectional study was conducted at the Department of Forensic Medicine, Rajshahi Medical College Hospital, Bangladesh, from July 2019 to July 2020. A total of 36 suspected narcotic exposure cases were included. Blood and urine samples were collected, preserved, and tested using rapid antigen test kits for commonly abused narcotic substances. Results were compared with available confirmatory forensic methods, including GC-MS, LC-MS/MS, or HPLC. Diagnostic performance was assessed by sensitivity, specificity, predictive values, accuracy, agreement rate, and kappa statistics.
Results: Among 36 forensic cases, urine samples were more common (20; 55.6%) than blood samples (16; 44.4%). Methamphetamine/Yaba was the most frequently detected substance (12; 33.3%), followed by cannabis/THC (7; 19.4%) and opiates/codeine-related substances (6; 16.7%). Overall, 30 (83.3%) of samples were positive by rapid antigen test, with slightly higher positivity in urine (85.0%) than in blood (81.3%). Among 35 valid samples, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93.1%, 50.0%, 90.0%, 60.0%, and 85.7%, respectively. Overall agreement with confirmatory methods was 85.7%, with moderately significant agreement (kappa = 0.46, p = 0.006).
Conclusion: Rapid antigen test kits are useful for preliminary forensic narcotic screening, especially in urine samples, but all medico-legally important results should be confirmed by GC-MS, LC-MS/MS, or HPLC before final reporting.
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