icol . ▁Where ▁doubt ▁exists , ▁the ▁diagn osis ▁may ▁be ▁confirmed ▁by ▁a ▁labor atory ▁test ▁such ▁as ▁ser ology . ▁Again , ▁this ▁is ▁often ▁un available ▁in ▁most ▁en demic ▁areas , ▁since ▁the ▁ser ological ▁test ▁involved ▁is ▁not ▁included ▁in ▁the ▁routine ▁screen ing ▁tests ▁for ▁P U O , ▁especially ▁in ▁Bur ma ▁( My an mar ). ▁ ▁The ▁choice ▁of ▁labor atory ▁test ▁is ▁not ▁straightforward , ▁and ▁all ▁currently ▁available ▁tests ▁have ▁their ▁limitations . ▁The ▁che apest ▁and ▁most ▁easily ▁available ▁ser ological ▁test ▁is ▁the ▁We il - F el ix ▁test , ▁but ▁this ▁is ▁not or iously ▁un re li able . ▁ ▁The ▁gold ▁standard ▁is ▁indirect ▁imm un of lu ores c ence , ▁but ▁the ▁main ▁limitation ▁of ▁this ▁method ▁is ▁the ▁avail ability ▁of ▁flu ores cent ▁micro scop es , ▁which ▁are ▁not ▁often ▁available ▁in ▁resource - po or ▁settings ▁where ▁scr ub ▁ty ph us ▁is ▁en demic . ▁ ▁Ind irect ▁imm un op ero x id ase , ▁a ▁modification ▁of ▁the ▁standard ▁I FA ▁method , ▁can ▁be ▁used ▁with ▁a ▁light ▁mic ros cope , ▁and ▁the ▁results ▁of ▁these ▁tests ▁are ▁compar able ▁to ▁those ▁from ▁I FA . ▁ ▁Rap id ▁bed side ▁k its ▁have ▁been ▁described ▁that ▁produce ▁a ▁result ▁within ▁one ▁hour , ▁but ▁the ▁avail ability ▁of ▁these ▁tests ▁is ▁sever ely ▁limited ▁by ▁their ▁cost . ▁ ▁Ser ological ▁methods ▁are ▁most