ABSTRACT
Introduction: We investigated the feasibility and validity of developing a system to monitor prescriptions prescribed by physicians for the promotion of appropriate antimicrobial use in clinics.Methods: The names of injuries and diseases and prescribed drugs stored in the receipt computers of six clinics were output and anonymized. Antimicrobial prescriptions for acute respiratory tract infections and acute diarrhea were compiled and evaluated.Results: Anonymized data were available for all six clinics. We were able to extract data and aggregate prescriptions by linking the name of the injuries and diseases to the prescribed drug.Conclusions: We consider it possible to establish antimicrobial stewardship in clinics through antimicrobial prescription monitoring and to develop such a system. On the other hand, there are multiple ways of naming injuries and diseases, and further investigation is needed to define the names of injuries and diseases to be extracted.
ABSTRACT
We encountered a probable case ofloiasis in a returned traveler from Central Africa. A 52-year-old Japanese womanpresented to our hospital complaining of discomfort in her eyes and skin. She reportedhaving frequently visited Central Africa over many years and having been extensivelyexposed to the rainforest climate and ecosystem. Although no microfilariae werefound in her blood, there was an elevated level of IgG antibodies against thecrude antigens of<i> Brugia pahangi</i>,which have cross-reactivity with <i>Loa loa</i>.She was treated with albendazole for 21 days, after which the antigen-specificIgG level decreased and no relapse occurred.
ABSTRACT
We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of <i>Brugia pahangi</i>, which have cross-reactivity with <i>Loa loa</i>. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.
ABSTRACT
Background: Rapid diagnostic tests (RDTs) have widely been used in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has previously been described in many reports, the low performance of RDTs particularly for <i>Plasmodium ovale</i> malaria in travellers have rarely been reported. Methods: This was retrospective cohort study conducted among Japanese travellers who were diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. Diagnosis of malaria by microscopic examination, RDT, and polymerase chain reaction were performed for all the patients. The RDTs used in our study were Binax NOW Malaria (Binax Inc., Scarborough, Maine, USA) (BN) and SD Malaria Antigen Pf/Pan (Standard Diagnostics Inc., Korea) (SDMA). We compared the sensitivity of the RDTs of <i>P. ovale</i> malaria with that of <i>Plasmodium vivax</i> malaria. Results: A total of 153 cases of malaria were observed, of which 113 patients were Japanese travellers. Nine patients with <i>P. ovale</i> malaria and 17 patients with <i>P. vivax</i> malaria performing RDTs were evaluated. The overall sensitivity of RDTs for <i>P. ovale</i> malaria was 22.2% and that for <i>P. vivax</i> malaria was 94.1% (P < 0.001). The sensitivity of SDMA for <i>P. vivax</i> malaria was 100% and that for <i>P. ovale</i> malaria was 50%. The sensitivity of BN for <i>P. vivax</i> malaria was 90.0%; however, it was unable to detect the cases of <i>P. ovale</i> malaria. Conclusions: The sensitivity of RDTs was not high enough to diagnose <i>P. ovale</i> malaria in our study. Thus, microscopic examination is indispensable not to overlook <i>P. ovale</i> malaria.
ABSTRACT
Background: Rapid diagnostic tests (RDTs) are used widely in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has been described in many previous studies, the low performance of RDT particularly for <i>Plasmodium ovale</i> malaria in traveller has rarely been reported. Methods: This was a retrospective cohort study conducted on Japanese travellers diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. The diagnosis of malaria was confirmed by microscopic examination, RDT, and polymerase chain reaction in all patients. The RDTs used in our study were Binax NOW Malaria (Binax Inc., Scarborough, Maine, USA) (BN) and SD Malaria Antigen Pf/Pan (Standard Diagnostics Inc., Korea) (SDMA). We compared the sensitivity of the RDTs to <i>P. ovale</i> malaria and <i>Plasmodium vivax</i> malaria. Results: A total of 153 cases of malaria were observed, 113 of which were found among Japanese travellers. Nine patients with <i>P. ovale</i> malaria and 17 patients with <i>P. vivax</i> malaria undergoing RDTs were evaluated. The overall sensitivity of RDTs for <i>P. ovale</i> malaria and <i>P. vivax</i> malaria was 22.2% and 94.1%, respectively (P < 0.001). The sensitivity of SDMA for <i>P. ovale</i> malaria and <i>P. vivax</i> malaria was 50% and 100%, respectively. The sensitivity of BN for <i>P. vivax</i> malaria was 90.0%, but it was ineffective in detecting the cases of <i>P. ovale</i> malaria. Conclusions: The sensitivity of RDTs was not high enough to diagnose <i>P. ovale</i> malaria in our study. In order not to overlook <i>P. ovale</i> malaria, therefore, microscopic examination is indispensable.