A three year retrospective study on the increasing trend in seroprevalence of dengue infection from southern Odisha, India.

Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India. Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification. Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes. Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.

Comparison of Two Rapid Immunochromatographic Assays (ICT Malaria P.f. /P.v. Test and OptiMAL Test) with Microscopy for Detection of Malaria Parasites.

This study was done to compare the ability of newly developed immunochromatographic assays (ICT), i.e., ICT malaria P.f. / P.v. test and optiMAL test with standard microscopy for the diagnosis of malaria. ICT P.f. / P.v. test detects Plasmodium falciparum specific histidine rich protein-2 (HRP2) antigen and a pan-malarial common specific antigen, where as optiMAL test detects P. falciparum specific parasite Lactate Dehydrogenase (pLDH) enzyme and a common specific pLDH enzyme. Material and Methods: Blood samples were obtained from 150 patients clinically diagnosed as malaria between July 2011 to December 2011.The venous blood were tested for malaria by microscopy and simultaneously ICT P.f./P.v.and optiMAL tests. Results: From total 150 samples, 59 (39.3%) were positive by blood films while 64 (42.7%) were positive by ICT p.f. / p.v. and 52 (34.7%) by optiMAL tests. The blood film indicated that 32.2% (19 of 59) of patients were positive for P. vivax and 67.8% (40 of 59) were infected with P. falciparum. ICT P.f./P.v. test showed 23.4% (15 of 64) were positive for P. vivax and 76.6% (49 of 64) were infected with P. falciparum. Similarly, optiMAL test detected 30.8% (16 of 52) were positive for P. vivax and 69.2% (36 of 52) were infected with P. falciparum. ICT P.f./P.v. test had sensitivities 78.9%, 87.5% and specificities 100%, 87.3% for P. vivax and P. falciparum respectively. optiMAL test showed sensitivities 84.2%, 80% and specificities 100%, 96.4% for P. vivax and P. falciparum respectively. Conclusion: These rapid immunoassays (ICT P.f./P.v. and optiMAL) tests can be used as supplementary to traditional light microscopy for the diagnosis of malarial parasites.

Pyopericardium due to infection with Mycobacterium tuberculosis - A rare case report.

Summary: Pyopericardium or purulent pericarditis is a rare entity but usually associated with a high mortality. We report a case of 30-year-old male presenting with pyopericardium due to Mycobacterium tuberculosis. The patient was treated with Anti-tubercular therapy (ATT) alongwith pericardiocentesis and pericardiectomy. The patient responded well to treatment and recovered completely in due course of time.

Laboratory diagnosis of chikungunya virus: Do we really need it.

Chikungunya (CHIK) fever is a re-emerging Aedes mosquito-transmitted viral disease caused by CHIK virus belonging to the Togaviridae family of genus Alphavirus. The disease is almost self-limiting, occurs with characteristic triad of sudden onset fever, rash and arthritis. During the recent outbreak CHIKV was also found to cause long-term arthralgia, severe neurological disease and even fatalities. Although there are no antiviral or vaccines available for CHIKV, still there are several advantages to diagnose the infection. The present article provides an overview of various diagnostic modalities available and its significance by searching PubMed MeSH terms "Chikungunya virus" and "Diagnosis" for recent articles. The gold standard of CHIKV diagnosis is culture, yet requires facilities and skills. Highly sensitive and specific PCR assays for CHIKV have been developed, but the reagents and equipment are costly for widespread use. Serological diagnosis by detecting IgM antibody is most widely used as it is relatively cheaper and easier to perform. Disadvantages of antibody testing are cross-reactivity with other alpha viruses, cannot differentiate between recent past and acute infection, and its sensitivity varies in clinical settings. When tested for diagnosing acute CHIKV disease, sensitivities were just 4 to 22% and after 1 week rose to more than 80%. As most acutely infected patients seek medical attention within the first few days of illness, the ideal test should detect RNA or antigen. Therefore, the more realistic aim would be to develop a reliable antigen detection assay that could be used in rural areas, where CHIKV infection often occurs.