Evaluation of OneStep Dengue NS1 RapiDip™ InstaTest and OneStep Dengue Fever IgG/IgM RapiCard™ InstaTest during the course of a dengue type 1 epidemic.

We determined the diagnostic performance of the OneStep NS1 and the OneStep IgG/IgM RDT kits against a panel of samples which comprised of 174 dengue positive and 165 dengue negative sera characterized by three reference enzyme-linked immunosorbent assays (ELISAs). The diagnostic sensitivities of the OneStep kits for the detection of individual biomarkers of NS1, IgM and IgG were 90% (95% CI: 82.1-94.7), 32.4% (95% CI: 24.8-40.8) and 44.4% (95% CI: 38.2-50.7), respectively. The combination of the OneStep IgG/IgM kit with the OneStep NS1 kit demonstrated significantly higher sensitivities for the combined NS1/IgM (96.8%; 95% CI: 90.9-99.3) and NS1/IgM/IgG (99.5%; 95% CI: 97.1-99.9)(P<0.001). In conclusion, the OneStep NS1 kit has high sensitivity and specificity and is highly recommended for use. The low sensitivities for IgG (44.4%) and for IgM (32.4%) of the OneStep IgG/IgM kit when used alone suggest it is best used in combination with the OneStep NS1 kit to enhance its overall diagnostic performance.

Success in controlling a major outbreak of malaria because of Plasmodium falciparum in Jamaica.

In 2006, after 44 years of eradication of malaria, Jamaica had an outbreak of Plasmodium falciparum: 406 confirmed cases between September 2006 and December 2009 with a peak of the epidemic in December 2006. In response to the outbreak, the Ministry of Health launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Ninety percent (361) of cases were residents of Kingston, and 63.6% were identified through house to house surveillance visits. For 56% of the confirmed cases, treatment with chloroquine was initiated within a week of onset of symptoms. Only one (0.3%) of 358 cases who had a post-treatment smear on day 7 had a persistent asexual parasitaemia, while none of the 149 persons who had a follow-up smear on day 28 was positive. The outbreak highlighted the need for increased institutional capacity for surveillance, confirmation and treatment of malaria as well as effective prevention and control of outbreaks which can occur after elimination. Jamaica appears to have successfully eliminated malaria after its reintroduction.

A systematic HIV/AIDS education programme for auxiliary staff in Jamaican hospitals - abstract

Between June and September 1990, a 90-minute lecture with group discussion about the human immuno-deficiency Virus (HIV) and the acquired immunodeficiency syndrome (AIDS) was held for auxiliary staff at each of the 21 government hospitals in Jamaica. After a pilot experiment in two hospitals, a standard teaching format was used in 21 further sessions at 19 sites, including information about HIV and AIDS, how HIV is and how it is not transmitted and relevant safety precautions. Pre/post tests were given at 20 of the 21 sessions. Data were analysed from all sessions where more than two-thirds of the participants completed valid pre- and post-tests. There were 286 valid paired forms from 13 sessions (12 hospitals). In pre-tests, mean scores ranged from 31 percent to 82 percent and were > 60 percent in 12 of 13 sessions. Only 22 percent of participants indicated knowing that AIDS is a group of diseases and 21 percent identified the correct minimum exposure time required to kill HIV with bleach. Only 42 percent acknowledged that they could catch HIV from a healthy-looking carrier. Mean post-test scores were significantly higher than pre-test scores in 12 of 13 hospitals (p < 0.001 eleven times; p< 0.03 once). However, < 50 percent of persons still said they could not catch HIV from a healthy-looking carrier (AU)