ABSTRACT
Objectives: To detect the diagnostic accuracy of rapid antibody detection test using IgM immunochromatography for scrub typhus in children. Methods: This cross-sectional study enrolled children aged 2 months-18 years hospitalized over a period of 18 months with undifferentiated fever of duration five days or more. The blood samples were subjected to serological tests like Weil-Felix, Scrub IgM ELISA, immunofluroscence assay (IFA) and rapid diagnostic test (IgM Immunochromatography). Diagnostic accuracy was measured against IFA as the gold standard. Results: A total of 90 children were included in the study, among which 43 children were positive for gold standard test IFA. Rapid diagnostic test showed sensitivity of 88.3%, specificity of 89.3%, positive predictive value of 88.3% and negative predictive value of 89.3%. The sensitivity, specificity, PPV and NPV of Weil-Felix test was 39.5%, 84.2%, 58.6 and 71.1%, respectively and of IgM ELISA was 93%, 89.3%,88.8% and 93.3%, respectively. Conclusion: IgM immunochromatography had good diagnostic accuracy for scrub typhus in children with acute undifferentiated fever.
ABSTRACT
Context and Aim: Given the challenges of microscopy, we compared its performance with SD Bioline malaria rapid diagnostic test (MRDT) and polymerase chain reaction (PCR) and evaluated the time it took for positive results to become negative after treatment of children with acute uncomplicated malaria. Subjects and Methods: We present the report of 485 participants with complete MRDT, microscopy, and PCR data out of 511 febrile children aged 359 months who participated in a cohort study over a 12 month period in rural and urban areas of Ibadan, Nigeria. MRDT positive children received antimalaria and tested at every visit over 28 days. Speciation was also carried out by PCR. Results: With microscopy as the gold standard, SD-Bioline™ had 95.2% sensitivity, 66.4% specificity, 67.5% positive predictive value (PPV), and 94.9 negative predictive value (NPV), while with PCR the findings were 84.3% sensitivity, 66.5% specificity, 72.7% PPV, and 80.1% NPV. PCR speciation of malaria parasites revealed 91.6% Plasmodium falciparum, 18.9% Plasmodium malariae, and 4.4% Plasmodium ovale. Among the 47 children with P. malariae infections, 66.0% were coinfected with P. falciparum, while 54.6% cases of P. ovale occurred as coinfections with P. falciparum. The median time to a negative MRDT was 23.2 days, while the median time to a negative malaria microscopy was 3.8 days. The two survival curves were significantly different. Conclusions: The SD BiolineTM MRDT performed well, with remarkable persistence of rapid test-positive for an average of 23 days post treatment. The prevalence of P. malaria is somewhat greater than expected.
Subject(s)
Humans , Male , Female , Child, Preschool , Sensitivity and Specificity , MalariaABSTRACT
@#Objective: This study aimed to determine sensitivity, specificity, and accuracy of RDT used in 4 health care centres in Vientiane capital versus ELISA. Methods: A study was then conducted among 1,729 patients who underwent three different RDTs for surface antigen of hepatitis virus (Boson, CTK and Coretest) in two public central hospitals and two private clinics in Vientiane Capital, to compare sensitivity, specificity, and accuracy of RDTs versus ELISA. Results: The mean age (95%CI) of the patients was 28.7 years old and the sex ratio was balanced. 13.71% of the patients had positive HBsAg as detected by ELISA, while this was only 8.9% for RDTs. All three types of RDTs had a sensitivity of 54% and specificity of 97%. There was no difference in accuracy, sensitivity, specificity, positive and negative predictive values between RDTs. Conclusions: This study revealed higher prevalence of HBsAg among young adults who were present in health care facilities in Vientiane than previously described in Laos. All three RDTs studied had low sensitivity but high specificity; therefore, they are likely to miss many cases of Hepatitis B infection and should be replaced or backed up by more accurate methods.
ABSTRACT
El uso de Plasma de Convaleciente de COVID-19 (PC-CoV19) como coadyuvante en el tratamiento de pacientes, tendría impacto socioeconómico importante al disminuir el periodo de estancia hospitalaria y letalidad por la enfermedad. La determinación de anticuerpos en plasma de potenciales donantes es criterio fundamental para su selección. Existe dificultad para disponer de pruebas serológicas certificadas que cuantifiquen anticuerpos específicos contra SARS-CoV-2. Las Pruebas de Diagnóstico Rápido (PDR) se convierten en herramienta útil y al alcance para la selección de pacientes recuperados, potenciales donantes de PC-CoV19. Este estudio evaluó el porcentaje de positividad de diferentes PDR en veintidós (22) muestras de pacientes con COVID-19 confirmada por RT-PCR. Las muestras se analizaron siguiendo el procedimiento descrito por cada fabricante. Se analizó el comportamiento de las PDR en pacientes sintomáticos y asintomáticos en diferentes momentos de la enfermedad. El porcentaje de positividad fue de 100% con dos de las tres pruebas utilizadas, una de las cuales discrimina IgM de IgG. Se concluye que la presencia de IgG se registra a partir de los 15 días del inicio de los síntomas y se mantiene presente a los 59 días de evolución en los pacientes sintomáticos, y que pacientes asintomáticos podrían ser considerados candidatos a donantes de PC-CoV19 pues se evidenció seroconversión para IgG. El porcentaje de positividad a IgG podría disminuir en los pacientes recuperados. Se sugiere que pacientes sintomáticos con criterio de alta médica sean considerados candidatos donantes en momento posterior a 28 días de la fecha de inicio de los síntomas. Se recomienda utilizar PDR que discriminen IgM de IgG como herramienta para la selección de donantes de PC-CoV19(AU)
The use of COVID-19 Convales-cent Plasma (PC-CoV19) as an ad-juvant for the treatment of patients, would have a significant socioeconomic impact by reducing the leng-th of hospital stay and lethality due to the disease. The determination of antibodies in plasma from potential donors is a fundamental criterion for their selection. There is dificulty in obtaining certified serological tests that quantify specific antibodies against SARS-CoV-2. Rapid Diagnostic Tests (PDR) become a useful and accessible tool in the selection of recovered patients, potential PC-CoV19 donors. This study evaluated the positivity rate of different PDRs in twenty two (22) samples from patients with COVID-19 confirmed by RT-PCR. The samples were analyzed following the procedure described by each manufacturer. The performance of PDRs was analyzed in symptomatic and asymptomatic patients at different times of the disease. The positivity rate was 100% with two of the three tests used, one of which discriminates IgM from IgG. It is concluded that the presence of IgG is recorded 15 days after the onset of symptoms and remains present at day 59 of evolution in symptomatic patients, and that asymptomatic patients could be considered candidates for PC-CoV19 donors since IgG se-reconversion was evident. The positivity rate to IgG could decrease in the recovered patients. It is suggested that symptomatic patients with medical discharge criteria be considered donor candidates after 28 days from the date of onset of symptoms. It is recommended to use PDRs that discriminate IgM from IgG as a tool for the selection of PC-CoV19 donors
Subject(s)
Humans , Plasma , Tissue Donors , Immunoglobulin G/therapeutic use , Immunoglobulin M , Serologic Tests , Coronavirus Infections , Diagnostic Tests, RoutineABSTRACT
Background & objectives: Dengue diagnosis is routinely carried out by detection of dengue virus (DENV) antigen NS1 and/or anti-DENV IgM antibodies using enzyme-linked immunosorbent assays (ELISAs) and rapid diagnostic tests (RDTs). This study was aimed at evaluation of quality of diagnostic assays currently in use in India for the identification of DENV infection. Methods: During 2016 dengue season (July-November) in Pune, India, comparative assessment of a few immunoassays was undertaken using (i) WHO-approved Panbio-Dengue-Early-(NS1)-ELISA and Panbio-Dengue-IgM-Capture-ELISA as reference tests, and (ii) Bayesian latent class analysis (BLCA) which assumes that no test is perfect. The assays included J.Mitra-Dengue-NS1-Ag-MICROLISA (JME-NS1), J.Mitra-Dengue-IgM-MICROLISA (JME-IgM), and two RDTs, namely, J.Mitra-Dengue-Day-1-Test (JM-RDT) and SD-BIOLINE-Dengue-Duo (SDB-RDT). Serum samples from patients seeking dengue diagnosis (n=809) were tested using the diagnostic kits. The presence of NS1 and/or IgM was taken as evidence for dengue-positive diagnosis. Results: Panbio-NS1/IgM-ELISAs identified 38.6 per cent patients as dengue positive. With Panbio-ELISA as reference, all the tests were less sensitive for IgM detection, while for NS1, JM-RDT was less sensitive. For combined diagnosis (both markers), sensitivity of all the tests was low (55.7-76.6%). According to BLCA, Panbio-ELISA was 84 per cent sensitive for NS1, 86 per cent specific for IgM and 87 per cent specific for combined diagnosis. Accordingly, performance of the other tests was substantially improved with BLCA; however, sensitivity of both the RDTs for IgM detection remained unacceptable. The NS1 ELISAs and RDTs detected all four DENV serotypes, JME being most efficient. All IgM tests exhibited higher sensitivity in secondary infections. Interpretation & conclusions: These results confirmed superiority of ELISAs, and testing for both NS1 and IgM markers for dengue diagnosis, and emphasized on improvement in sensitivity of RDTs.
ABSTRACT
Objective To analyze the diagnosis of imported malaria cases in Henan Province from 2015 to 2019, so as to provide the evidence for malaria surveillance during the post-elimination stage. Methods The data pertaining to malaria cases in Henan Province from 2015 to 2019 were extracted via the web-based Chinese Information System for Infectious Diseases Control and Prevention and the Parasitic Diseases Information Reporting Management System (PDIRMS) of Chinese Center for Disease Control and Prevention, and the diagnostic methods, diagnostic institutions and diagnostic time of imported malaria cases were analyzed. Results A total of 952 imported malaria cases were reported in Henan Province during the period from 2015 through 2019, and all cases were laboratory-confirmed. The positive rate of malaria rapid diagnostic tests (RDTs) was 98.61% (779/790), which was significantly greater than that (94.22%, 897/952) of microscopic examinations (χ2 = 22.773, P < 0.05). The proportion of imported malaria cases diagnosed in medical institutions increased from 65.22% (120/184) in 2015 to 81.50% (185/227) in 2019. Among the 238 imported malaria cases diagnosed in centers for disease control and prevention (CDC), 71.01% (169/238) were diagnosed in county-level CDC, and among the 704 cases diagnosed in medical institutions, only 8.38% (59/704) were diagnosed at county-level medical institutions. The median time from onset to definitive diagnosis of malaria was 3 days, and the median duration between onset and initial diagnosis of malaria was 1 day. The duration between initial diagnosis and definitive diagnosis of malaria varied significantly among years (χ2 = 24.956, P < 0.05), and the interquartile range from initial diagnosis to definitive diagnosis reduced from 4 days in 2016 to 2 days in 2019. In addition, the median time from initial diagnosis to definitive diagnosis was significantly longer in severe falciparum malaria cases than in non-severe falciparum malaria cases (2 days vs. 1 day; Z = 7.557, P < 0.05). Conclusions Medical institutions play a more and more important role in the identification and surveillance of malaria cases; however, the diagnostic capability of malaria remains low in county-level medical institutions. The diagnostic awareness and capability of county-level medical institutions requires to be improved, in order to play their roles as sentinel hospitals in the malaria surveillance during the post-elimination stage.
ABSTRACT
Purpose: Sensitive, specific, rapid and cost-effective technique for malaria diagnosis is need of the hour. Microscopy has been the gold standard for malaria diagnosis, but its interpersonnel variability and lack of sensitivity make it subjective test. Conventional polymerase chain reaction (cPCR) has proven to be sensitive technique, but costly and time-consuming. Considering these factors, we have compared microscopy and cPCR with newly derives ultra-fast, portable PCR machine called Palm PCR. Materials and Methods: Palm PCR is arranged with three heat blocks precisely made for three stages of PCR cycles with 34 min for 1100 bp Plasmodium genus outer primer to amplify and 10 min each for Plasmodium falciparum and Plasmodium vivax inner primers of 120 bp and 205 bp, respectively. A total of 191 suspected samples were processed and evaluated using receiver operating characteristic (ROC) curve analysis. Results: The area under ROC curve analysis for Palm PCR with reference standard microscopy for P. falciparum, P. vivax and Plasmodium was 0.8969, 0.9121 and 0.9116, respectively, and with reference standard cPCR was 1.0 for all of them. ROC curve area close of suggests that Palm PCR can be as significant as cPCR in malaria diagnosis. In fact, ultra-rapid amplification with same precision makes Palm PCR better technique than cPCR. Conclusion: Palm PCR is sensitive, rapid and works on battery with simple laboratory facility requirements. Portable electrophoresis and transilluminator combined with Palm PCR could be implemented as an important diagnostic tool in resource-limited and rural areas. Similar studies with wider parameters in rural areas will help us evaluate and maybe establish Palm PCR as PCR platform of choice for such specific set-ups.
ABSTRACT
Background: Dengue fever often presents as an undifferentiated febrile illness requiring a laboratory test for identification. Serological tests particularly on rapid kits for the detection of NS1Antigen, IgG and IgM antibodies are the most commonly performed test across the country.Methods: The serum samples of suspected dengue cases were tested by Rapid test kits for assessing all the three parameters as well as by ELISA for NS1 antigen test. The platelet count of the patients was obtained from automated coulter counter. The results thus obtained were analyzed in Excel format.Results: The serum samples from 304 suspected Dengue fever cases were received in the lab, of which 190 samples were positive either by rapid or ELISA and 176 when rapid card test was considered alone Highest seropositivity of dengue cases were observed in the age group of ≥60 years (79.2%) followed by 45-59 years (70.7%). On rapid test, 78 cases were NS1 antigen positive of which 60 cases were positive only for NS1 antigen. When NS1 rapid and ELISA tests when compared, 16 kit negative tests were positive on ELISA while 34 kit positive tests were ELISA negative. Sensitivity, specificity, PPV and NPV when only NS1 was considered on rapid test kits when compared with ELISA were 78.9%, 87.8%, 63.8% and 93.8%. 33.5% of serologically positive cases of Dengue had low platelet count on admission while only among negative cases 17.2% had a low platelet.Conclusions: Rapid kits often show variable results thus needing a validation of them from end user. As a positive dengue test result is an essential prerequisite for diagnosis thus it is essential that for serological tests ELISA technique should be used for reporting. Thus, it also mandates more efforts at decentralization of NVBDCP to include both government and non government institutions.
ABSTRACT
Objective To perform epidemiological survey and laboratory diagnosis of a Plasmodium ovale malaria case imported into Hefei City, so as to provide scientific evidence for the prevention and control of imported malaria in the future. Methods The epidemiological history and clinical data of the imported malaria case were collected and analyzed. Results The patient returned to China from Mozambique, and was admitted to the hospital due to repeated fever several months after returning to China. Rapid diagnostic test (RDT) suggested non-P. falciparum infection, and microscopy displayed normal or slightly swelled malaria parasite-infected erythrocytes, unapparent serrated changes, increased cytoplasm in large trophozoite with irregular morphology, and almost no vacuoles. qPCR assay revealed P. ovale infection. Conclusions Clinical medical professionals should improve their awareness of malaria diagnosis in people with a history of living or working in overseas malaria-epidemic areas, and early and rational administration of antimalarials should be given promptly to prevent the spread of malaria epidemics.
ABSTRACT
Objective To perform epidemiological survey and laboratory diagnosis of a Plasmodium ovale malaria case imported into Hefei City, so as to provide scientific evidence for the prevention and control of imported malaria in the future. Methods The epidemiological history and clinical data of the imported malaria case were collected and analyzed. Results The patient returned to China from Mozambique, and was admitted to the hospital due to repeated fever several months after returning to China. Rapid diagnostic test (RDT) suggested non-P. falciparum infection, and microscopy displayed normal or slightly swelled malaria parasite-infected erythrocytes, unapparent serrated changes, increased cytoplasm in large trophozoite with irregular morphology, and almost no vacuoles. qPCR assay revealed P. ovale infection. Conclusions Clinical medical professionals should improve their awareness of malaria diagnosis in people with a history of living or working in overseas malaria-epidemic areas, and early and rational administration of antimalarials should be given promptly to prevent the spread of malaria epidemics.
ABSTRACT
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
ABSTRACT
Abstract INTRODUCTION: Rapid diagnostic tests (RDTs) for detecting Plasmodium antigens have become increasingly common worldwide. We aimed to evaluate the accuracy of the Immuno-Rapid Malaria Pf/Pv RDT in detecting Plasmodium vivax infection compared to standard thick blood smear (TBS) under microscopy. METHODS: Hundred and eighty-one febrile patients from the hospital's regular admissions were assessed using TBS and RDT in a blinded experiment. RESULTS: RDT showed a sensitivity of 98.9%, specificity of 100%, and accuracy of 99.5% for P. vivax infection when compared to TBS. CONCLUSIONS: The RDT is highly accurate, making it a valuable diagnostic tool for P. vivax infection.
Subject(s)
Humans , Male , Female , Adult , Plasmodium falciparum/immunology , Plasmodium vivax/immunology , Malaria, Vivax/diagnosis , Malaria, Falciparum/diagnosis , Diagnostic Tests, Routine/methods , Antigens, Protozoan/immunology , Brazil , Prospective Studies , Sensitivity and SpecificityABSTRACT
Rapid diagnostic tests (RDTs) for malaria using antibodies against pan-Plasmodium antigen lactate dehydrogenase (pLDH) are commonly used for malaria diagnosis. The level of malaria parasitemia determined by peripheral blood smears (PBS) correlates with the pLDH concentration in most cases. We report a case of malaria recurrence associated with false-negative RDT results. A 22-year-old male patient was admitted to the Armed Forces Capital Hospital with fever and chills, and was diagnosed with malaria infection. Four days after antimalarial treatment, these symptoms recurred. After admitting to our hospital, doxycycline was administered for 4 days. Even after administration of doxycycline, the malaria parasites in blood smears remained positive, but RDT showed negative results. Therefore, for patients receiving doxycycline, serial blood smear testing should be performed to exclude false-negative malaria RDT results.
Subject(s)
Humans , Male , Young Adult , Antibodies , Arm , Chills , Diagnosis , Diagnostic Tests, Routine , Doxycycline , Fever , L-Lactate Dehydrogenase , Malaria , Parasitemia , Parasites , RecurrenceABSTRACT
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
ABSTRACT
Objective@#To investigate the current status of malaria rapid diagnostic test (RDT) strips application and malaria laboratory technicians' evaluation about them at primary healthcare provider level in Jiangsu Province.@*Methods@#From November to December 2016, 878 medical institutions and 118 CDCs of city, county and township/community level in Jiangsu Province were selected as study samples using stratified random sampling method. Self-designed questionnaire was distributed to investigate the institution's malaria work task, RDT strips application and evaluation status in 2015. We also investigated the socio-demographic information and collected the RDT strips evaluation score from the malaria laboratory technicians selected from the institutions investigated (one technician from each institution). Rank sum test was performed to compare the RDT strips evaluation scores between medical institutions and CDCs, and among different medical institutions and CDCs.@*Results@#In 2015, 405 cases of malaria were reported, 362 200 person-time of malaria blood testing task was conducted, and 100 000 RDT strips were procured and provided for healthcare providers in Jiangsu province for free. Of the 996 healthcare institutions investigated, 628 used RDT strips in the year 2015 and the median (P25, P75) of RDT strips volume used in these institutions was 10 (2, 25). The volume of RDT strips used in CDCs (15 (5, 52)) was significantly higher than that in medical institutions (10 (2, 25), (Z=3.42, P=0.001)). The investigated CDCs gave higher score on RDT strips' testing time per operation (10 (8.5, 10)) than medical institutions (9(8, 10), (Z=-2.20, P=0.028)). The employers of 614 investigated malaria laboratory technicians used RDT strips in 2015. The median of the scores given by CDC malaria laboratory technicians for RDT strips in terms of testing time per operation, testing operation and results judgement difficulties were 10 (9, 10), 10 (9, 10) and 10 (9, 10), respectively, which were significantly higher than those from technicians of medical institutions (9 (8, 10), 9 (8, 10), 9 (8, 10), (Z values were -2.55, -2.97 and -2.96, respectively; P values were all less than 0.05)).@*Conclusion@#RDT strips had been widely performed in health institutions in Jiangsu Province. The amount of RDT strips used in CDCs was significantly higher than that in medical institutions. Primary-level institutions and malaria laboratory technicians generally recognized RDT strips' advantage for application in terms of testing time and operational procedure. CDCs and malaria laboratory technicians from them gave higher regards on RDT strips in terms of testing time per operation, testing operation and results judgement difficulties compared with that of medical institutions.
ABSTRACT
BACKGROUND: Chemoprophylaxis has been used to prevent malaria among soldiers and secondary transmission, as it effectively facilitates a decline in disease occurrence and secondary prevention. However, poor compliance and decreased risk of exposure to malaria necessitate that control strategies be reestablished. METHODS: To predict the incidence of malaria according to a control strategy, we proposed a mathematical model for its transmission using epidemiological data from 2010 to 2012. The benefit component included in the analyses was the averted cost with each control strategy, and the cost components were the cost of implementing chemoprophylaxis and early diagnosis. RESULTS: The chemoprophylaxis regimen with hydroxychloroquine sulfate and primaquine was Intervention 1, the regimen with primaquine only was Intervention 2, and diagnosis with a rapid diagnostic test (RDT) kit within 5 days of fever was Intervention 3. The simulation indicated that the combined control program with chemoprophylaxis and early diagnosis would be the most effective strategy, whereas sole early diagnosis would be the least effective strategy. However, the cost-benefit ratio of chemoprophylaxis was less than Intervention 1, irrespective of the varying range of chemoprophylaxis compliance, and that of early diagnosis was more than Intervention 1, regardless of the varying early diagnosis rate and demand for the RDT kit. Although chemoprophylaxis would be more effective at reducing the incidence of malaria than early diagnosis, it is less economical due to the higher cost. CONCLUSION: Our results support the introduction of early diagnosis with a RDT kit to control malaria in the Republic of Korea Army.
Subject(s)
Humans , Chemoprevention , Compliance , Cost-Benefit Analysis , Diagnosis , Diagnostic Tests, Routine , Early Diagnosis , Fever , Hydroxychloroquine , Incidence , Malaria , Military Personnel , Models, Theoretical , Primaquine , Republic of Korea , Secondary PreventionABSTRACT
Malaria remains one of the leading health burdens in the developing world, especially in several sub-Saharan Africa countries; and Uganda has some of the highest recorded measures of malaria transmission intensity in the world. It is evident that the prevalence of malaria infection, the incidence of disease, and mortality from severe malaria remain very high in Uganda. Although the recent stable political and economic situation in the last few decades in Uganda supported for a fairly good appreciation of malaria control, the declines in infection, morbidity, and mortality are not sufficient to interrupt transmission and this country is among the top 4 countries with cases of malaria, especially among children under 5 years of age. In fact, Uganda, which is endemic in over 95% of the country, is a representative of challenges facing malaria control in Africa. In this study, we evaluated an active case detection program in 6 randomly selected villages, Uganda. This program covered a potential target population of 5,017 individuals. Our team screened 12,257 samples of malaria by active case detection, every 4 months, from February 2015 to January 2017 in the 6 villages (a total of 6 times). This study assessed the perceptions and practices on malaria control in Kiyuni Parish of Kyankwanzi district, Uganda. Our study presents that the incidence of malaria is sustained high despite efforts to scale-up and improve the use of LLINs and access to ACDs, based on the average incidence confirmed by RDTs.
Subject(s)
Child , Humans , Africa , Africa South of the Sahara , Health Services Needs and Demand , Incidence , Malaria , Mortality , Prevalence , UgandaABSTRACT
Prompt diagnosis of malaria cases with rapid diagnostic tests (RDTs) has been widely adopted as an effective malaria diagnostic tool in many malaria endemic countries, primarily due to their easy operation, fast result output, and straightforward interpretation. However, there has been controversy about the diagnostic accuracy of RDTs. This study was conducted to evaluate the diagnostic performances of the 2 commercially available malaria RDT kits, RapiGEN Malaria Ag Pf/Pv (pLDH/pLDH) and Asan EasyTestTM Malaria Ag Pf/Pv (HRP-2/pLDH) for their abilities to detect Plasmodium species in blood samples collected from Ugandan patients with malaria. To evaluate the diagnostic performances of these 2 RDT kits, 229 blood samples were tested for malaria infection by microscopic examination and a species-specific nested polymerase chain reaction. The detection sensitivities for P. falciparum of Malaria Ag Pf/Pv (pLDH/pLDH) and Asan EasyTestTM Malaria Ag Pf/Pv (HRP-2/pLDH) were 87.83% and 89.57%, respectively. The specificities of the 2 RDTs were 100% for P. falciparum and mixed P. falciparum/P. vivax infections. These results suggest that the 2 RDT kits showed reasonable levels of diagnostic performances for detection of the malaria parasites from Ugandan patients. However, neither kit could effectively detect P. falciparum infections with low parasitaemia ( < 500 parasites/μl).
Subject(s)
Humans , Diagnosis , Diagnostic Tests, Routine , Malaria , Parasites , Plasmodium , Polymerase Chain Reaction , Reagent Kits, Diagnostic , UgandaABSTRACT
Objective To evaluate the performance of parallel test in detecting malaria infection for returned person from malaria endemic area.Methods The blood samples of 484 returnees from malaria endemic area were analyzed and detected by thick blood smear,rapid diagnostic test (RDT) and nest PCR in four companies involving the African labor dispatching.Results The sensitivi ty of thick blood smear and RDT was 0.628 and 0.744 respectively,which of the parallel test was 0.930.On the other hand,the area under the curve (AUC) of parallel test was 0.930 (95％CI:0.895-0.986),which was higher than thick blood smear[0.814 (95％CI:0.724-0.904)]and RDT[0.847 (95％CI:0.769-0.926)].Conclusion Thick blood smear and RDT,which consist of parallel test,could improve the detection sensitivity and accuracy for returnees from malaria epidemical area effectively.This approach is worthy of popularization and application.
ABSTRACT
Seroprevalence of Toxoplasma gondii infection among the residents of Seokmo-do (Island) in Ganghwa-gun, Incheon, Korea was surveyed for 4 years by a rapid diagnostic test (RDT) using recombinant fragment of major surface antigen (SAG1), GST-linker-SAG1A. Sera from 312, 343, 390, and 362 adult residents were collected on a yearly basis from 2010 to 2013, respectively. Total positive seroprevalence regardless of gender was 29.2, 35.3, 38.7, and 45.3% from 2010 to 2013, respectively. Positive seroprevalence in male adults was 43.9, 48.2, 45.4, and 55.3%, which was far higher than that of the corresponding female adults which was 20.7, 29.2, 33.9, and 38.9%, from 2010 to 2013, respectively. This high seroprevalence of toxoplasmosis in Seokmo-do may have been caused in part by peculiar changes in the toxoplasmic environment of the island as it is a relatively isolated area preserving its natural habitat while also being connected by a bridge to the mainland. Further study is necessary to find out symptomatic patients and to confirm the risk factors.