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Evaluation of the Palutop+4 malaria rapid diagnostic test in a non-endemic setting
No full textBACKGROUND: Palutop+4 (All. Diag, Strasbourg, France), a four-band malaria rapid diagnostic test (malaria RDT) targeting the histidine-rich protein 2 (HRP-2), Plasmodium vivax-specific parasite lactate dehydrogenase (Pv-pLDH) and pan Plasmodium-specific pLDH (pan-pLDH) was evaluated in a non-endemic setting on stored whole blood samples from international travellers suspected of malaria. METHODS: Microscopy corrected by PCR was the reference method. Samples include those infected by Plasmodium falciparum (n = 323), Plasmodium vivax (n = 97), Plasmodium ovale (n = 73) and Plasmodium malariae (n = 25) and 95 malaria negative samples. RESULTS: The sensitivities for the diagnosis of P. falciparum, P. vivax, P. malariae and P. ovale were 85.1%, 66.0%, 32.0% and 5.5%. Sensitivities increased at higher parasite densities and reached 90.0% for P. falciparum >100/microl and 83.8% for P. vivax > 500/microl. Fourteen P. falciparum samples reacted with the Pv-pLDH line, one P. vivax sample with the HRP-2 line, and respectively two and four P. ovale and P. malariae samples reacted with the HRP-2 line. Two negative samples gave a signal with the HRP-2 line. Faint and weak line intensities were observed for 129/289 (44.6%) HRP-2 lines in P. falciparum samples, for 50/64 (78.1%) Pv-pLDH lines in P. vivax samples and for 9/13 (69.2%) pan-pLDH lines in P. ovale and P. malariae samples combined. Inter-observer reliabilities for positive and negative readings were excellent for the HRP-2 and Pv-pLDH lines (overall agreement > 92.0% and kappa-values for each pair of readers >or= 0.88), and good for the pan-pLDH line (85.5% overall agreement and kappa-values >or= 0.74). CONCLUSIONS: Palutop+4 performed moderately for the detection of P. falciparum and P. vivax, but sensitivities were lower than those of three-band malaria RDTs
Buruli ulcer in West Africa: strategies for early detection and treatment in the antibiotic era
No full textOBJECTIVE: Buruli ulcer (BU), caused by Mycobacterium ulcerans infection, has become one of the most rapidly emerging diseases in West Africa in recent decades. Until recently, the definitive treatment involved wide surgical excision. Recent data suggest that antibiotic therapy with rifampin and streptomycin may reduce the extent or prevent excision when initiated during the early phases of the disease. New strategies for BU control are needed, emphasizing early detection and increasing public awareness about the disease and treatment. Here we review current knowledge about BU and examine clinical, public health and anthropological research in the context of this new treatment paradigm to identify potential strategies for more effective control of this disease. METHODS: A comprehensive literature search for articles in English or French using the Medline and INIST databases, World Health Organization publications, and bibliographical references was undertaken using key words Buruli ulcer. Mycobacterium ulcerans, community surveillance, and public health. CONCLUSION: Studies to identify factors contributing to delayed presentation indicate that awareness of the disease is generally good in endemic regions, but wide variation exists in perceived cause of the disease, and the role of sorcery in its transmission and treatment. The use of traditional healers as first line therapy also contributes to delayed treatment, as do lack of awareness about the availability of effective treatment and financial concerns. Epidemiological data from existing BU control programs indicate that active public awareness campaigns are succcessful in increasing understanding and decreasing treatment delay and disease progression. Community-based surveillance and health education modeled after the village health worker programs used in the eradication of Guinea worm may be successfully applied in BU endemic areas
Report of the thirteenth WHOPES working group meeting: WHO/HQ, Geneva, 28-30 July 2009: review of Olyset® LN, Dawaplus® 2.0 LN, Tianjin Yorkool® LN
No full textReport of the twelfth WHOPES working group meeting: WHO/HQ, Geneva, 8-11 December 2008: review of Bioflash® GR, Permanet® 2.0, Permanet® 3.0, Permanet® 2.5, Lambda-Cyhalothrin LN
No full textResponse to "Case of yellow fever vaccine-associated viscerotropic disease with prolonged viremia, robust adaptive immune responses, and polymorphisms in CCR5 and RANTES genes" [letter]
No full textIndividual efficacy of intermittent preventive treatment with sulfadoxine-pyrimethamine in primi- and secundigravidae in rural Burkina Faso: impact on parasitaemia, anaemia and birth weight
No full textThe definitive version is available at www3.interscience.wiley.comSummary Objective To assess the efficacy at individual level of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) in primi- and secundigravidae in rural Burkina Faso. Methods Data of 1441 women enrolled in a health centre randomized trial and delivering a live-singleton between September 2004 and October 2006 were analysed at individual level. Prevalence of peripheral and placental parasitaemia, anaemia (PCV <33%), low-birth weight (<2500 g; LBW), mean packed cell volume (PCV) and birth weight were compared in relation to the number of directly observed SP doses. Results Two or more doses of SP significantly reduced the risk of placental parasitaemia [adjusted odds ratio (AOR) = 0.04, 95%CI = 0.003-0.60, P = 0.023] and anaemia at delivery (AOR = 0.31, 95%CI = 0.18-0.52, P < 0.001). IPTp was associated with reduced risk of LBW in primigravidae (AOR = 0.11, 95%CI = 0.07-0.17, P < 0.001) but not secundigravidae (AOR = 0.70, 95%CI = 0.26-1.91, P = 0.452). For each increment in number of SP doses mean PCV increased by 1.0% (95%CI = 0.4-1.7, P = 0.005) at 32 weeks gestation, by 1.2% (95%CI = 0.2-2.2, P = 0.025) at delivery and mean birth weight by 220 g (95%CI = 134-306 P < 0.001) in primigravidae and by 102 g (95%CI = 55-148, P = 0.001) in secundigravidae. Conclusion The risk of malaria infection was significantly reduced by IPTp with SP in primi- and secundigravidae in rural Burkina Faso. The impact on clinical outcomes is lower and mainly limited to primigravidae for LBW. Incomplete uptake of IPTp-SP and limited effect in low risk groups together may substantially dilute the measurable impact of effective interventions. This needs to be taken into account when evaluating interventions at community level
Molecular diagnosis of Strongyloides stercoralis in faecal samples using real-time PCR
No full textA real-time PCR method targeting the small subunit of the rRNA gene was developed for the detection of Strongyloides stercoralis DNA in faecal samples, including an internal control to detect inhibition of the amplification process. The assay was performed on a range of well-defined control samples (n=145), known positive faecal samples (n=38) and faecal samples from a region in northern Ghana where S. stercoralis infections are highly endemic (n=212), and achieved 100% specificity and high sensitivity. The use of this assay could facilitate monitoring the prevalence and intensity of S. stercoralis infections during helminth intervention programs. Moreover, the use of this assay in diagnostic laboratories could make the introduction of molecular diagnostics feasible in the routine diagnosis of S. stercoralis infections, with a two-fold increase in the detection rate as compared with the commonly used Baermann sedimentation method