11 research outputs found
Characteristics of the patients included in the prospective evaluation.
a<p>interquartile range.</p>b<p>72 samples were tested by the conventional nested RT-PCR and 85 were tested by real-time RT-PCR.</p>c<p>Absence of second serum.</p>d<p>Dengue diagnosis based solely on positive serology.</p>e<p>Medical record missing.</p
Field Evaluation and Impact on Clinical Management of a Rapid Diagnostic Kit That Detects Dengue NS1, IgM and IgG
<div><h3>Background</h3><p>Dengue diagnosis is complex and until recently only specialized laboratories were able to definitively confirm dengue infection. Rapid tests are now available commercially making biological diagnosis possible in the field. The aim of this study was to evaluate a combined dengue rapid test for the detection of NS1 and IgM/IgG antibodies. The evaluation was made prospectively in the field conditions and included the study of the impact of its use as a point-of-care test for case management as well as retrospectively against a panel of well-characterized samples in a reference laboratory.</p> <h3>Methodology/Principal Findings</h3><p>During the prospective study, 157 patients hospitalized for a suspicion of dengue were enrolled. In the hospital laboratories, the overall sensitivity, specificity, PPV and NPV of the NS1/IgM/IgG combination tests were 85.7%, 83.9%, 95.6% and 59.1% respectively, whereas they were 94,4%, 90.0%, 97.5% and 77.1% respectively in the national reference laboratory at Institut Pasteur in Cambodia. These results demonstrate that optimal performances require adequate training and quality assurance. The retrospective study showed that the sensitivity of the combined kit did not vary significantly between the serotypes and was not affected by the immune status or by the interval of time between onset of fever and sample collection. The analysis of the medical records indicates that the physicians did not take into consideration the results obtained with the rapid test including for care management and use of antibiotic therapy.</p> <h3>Conclusions</h3><p>In the context of our prospective field study, we demonstrated that if the SD Bioline Dengue Duo kit is correctly used, a positive result highly suggests a dengue case but a negative result doesn't rule out a dengue infection. Nevertheless, Cambodian pediatricians in their daily practice relied on their clinical diagnosis and thus the false negative results obtained did not directly impact on the clinical management.</p> </div
Sensitivity of individual and combination of tests according to serotype and immune status.
a<p>one-side, 97,5% confidence interval.</p
Concordance of the IgM/IgG tests between hospitals' laboratories and IPC.
<p>Concordance of the IgM/IgG tests between hospitals' laboratories and IPC.</p
Sensitivity of SD Bioline Dengue Duo NS1 test according to antibodies profile.
*<p>P-value refers to the comparison between profile 1 and 2.</p>**<p>P-value refers to the comparison between profile 3 and 4.</p
Concordance of the NS1 test between hospitals' laboratories and IPC.
<p>Concordance of the NS1 test between hospitals' laboratories and IPC.</p
Performances of the kit against confirmed and probable dengue cases in hospitals and IPC.
*<p>Mc Nemar test.</p>**<p>Fisher exact test.</p
Sensitivity of SD Bioline Dengue Duo kit.
<p>Evaluation of the sensitivity of NS1 test, IgM/IgG test and combination of the two tests depending on day of sampling after onset of fever.</p
Melioidosis in lower provincial Cambodia: A case series from a prospective study of sepsis in Takeo Province
<div><p>Melioidosis is a severe infectious disease caused by the gram-negative soil bacterium <i>Burkholderia pseudomallei</i>. Melioidosis is well known to be a major cause of morbidity and mortality in Southeast Asia, particularly in Thailand. However, melioidosis remains underreported in surrounding areas such as Cambodia. We report a case series of melioidosis in seven patients from Takeo Province, Cambodia. The patients, aged 24–65 years, were enrolled from May 2014 to May 2015 during a one year prospective study of sepsis at Takeo Provincial Hospital. They presented with fever, rigors, dyspnea, fatigue, diaphoresis, productive cough, and skin abscesses. Six of the seven patients were also hyponatremic. <i>B</i>. <i>pseudomallei</i> was cultured from the blood of six patients and the sputum of one patient. In this manuscript, we provide a detailed description of the clinical presentation, case management and laboratory confirmation of <i>B</i>. <i>pseudomallei</i>, as well as discuss the difficulties of identifying and treating melioidosis in low resource settings.</p></div
Study site.
<p>We used DIVA-GIS (<a href="http://diva-gis.org/" target="_blank">http://diva-gis.org/</a>) to create a map of Cambodia and surrounding areas. The red H indicates Takeo Provincial Hospital, the study site for this work. Dots indicate the location of the home village of seven melioidosis patients. Map is reflective of Cambodian Provincial borders during the time of patient enrollment.</p