Development and clinical performance of high throughput loop-mediated isothermal amplification for detection of malaria.

BACKGROUND: Accurate and efficient detection of sub-microscopic malaria infections is crucial for enabling rapid treatment and interruption of transmission. Commercially available malaria LAMP kits have excellent diagnostic performance, though throughput is limited by the need to prepare samples individually. Here, we evaluate the clinical performance of a newly developed high throughput (HTP) sample processing system for use in conjunction with the Eiken malaria LAMP kit. METHODS: The HTP system utilised dried blood spots (DBS) and liquid whole blood (WB), with parallel sample processing of 94 samples per run. The system was evaluated using 699 samples of known infection status pre-determined by gold standard nested PCR. RESULTS: The sensitivity and specificity of WB-HTP-LAMP was 98.6% (95% CI, 95.7-100), and 99.7% (95% CI, 99.2-100); sensitivity of DBS-HTP-LAMP was 97.1% (95% CI, 93.1-100), and specificity 100% against PCR. At parasite densities greater or equal to 2 parasites/μL, WB and DBS HTP-LAMP showed 100% sensitivity and specificity against PCR. At densities less than 2 p/μL, WB-HTP-LAMP sensitivity was 88.9% (95% CI, 77.1-100) and specificity was 99.7% (95% CI, 99.2-100); sensitivity and specificity of DBS-HTP-LAMP was 77.8% (95% CI, 54.3-99.5) and 100% respectively. CONCLUSIONS: The HTP-LAMP system is a highly sensitive diagnostic test, with the potential to allow large scale population screening in malaria elimination campaigns

Analytical sensitivity of current best-in-class malaria rapid diagnostic tests

BACKGROUND: Rapid diagnostic tests (RDTs) are today the most widely used method for malaria diagnosis and are recommended, alongside microscopy, for the confirmation of suspected cases before the administration of anti-malarial treatment. The diagnostic performance of RDTs, as compared to microscopy or PCR is well described but the actual analytical sensitivity of current best-in-class tests is poorly documented. This value is however a key performance indicator and a benchmark value needed to developed new RDTs of improved sensitivity. METHODS: Thirteen RDTs detecting either the Plasmodium falciparum histidine rich protein 2 (HRP2) or the plasmodial lactate dehydrogenase (pLDH) antigens were selected from the best performing RDTs according to the WHO-FIND product testing programme. The analytical sensitivity of these products was evaluated using a range of reference materials including P. falciparum and Plasmodium vivax whole parasite samples as well as recombinant proteins. RESULTS: The best performing HRP2-based RDTs could detect all P. falciparum cultured samples at concentrations as low as 0.8 ng/mL of HRP2. The limit of detection of the best performing pLDH-based RDT specifically detecting P. vivax was 25 ng/mL of pLDH. CONCLUSION: The analytical sensitivity of P. vivax and Pan pLDH-based RDTs appears to vary considerably from product to product, and improvement of the limit-of-detection for P. vivax detecting RDTs is needed to match the performance of HRP2 and Pf pLDH-based RDTs for P. falciparum. Different assays using different reference materials produce different values for antigen concentration in a given specimen, highlighting the need to establish universal reference assays

Caracterización programas de promoción y prevención en el uso de sustancias psicoactivas en las instituciones educativas adscritas a los udel del i al ix de Villavicencio

TablasEl propósito fundamental de este proyecto, es caracterizar los programas de promoción y prevención del uso de sustancias psicoactivas implementados en las Instituciones Educativas (I.E.), las cuales hacen parte de las Unidades de Desarrollo Educativo Local (UDEL) I al IX de Villavicencio, Meta - Colombia, y así observar su estructura en cuanto al dominio de conceptos, de ser, saber y hacer, su forma de aplicación, intensidad y metodología utilizada. La Investigación es mixta de tipo descriptivo “busca especificar las propiedades, características, y los perfiles importantes de personas, grupos, comunidades o cualquier otro fenómeno que se someta a un análisis” (Danhke, 1989). De igual manera desde la Investigación Acción (IA) que representa el análisis de la realidad desde experiencias de intervención social, con el fin de, “propiciar el cambio social, convertir la realidad y que las personas tomen conciencia de su papel en ese proceso de transformación” (Sandín, 2003).Se seleccionó la muestra de forma intencional, en 60 Instituciones Educativas, de las cuales 55 dieron respuesta a una entrevista semiestructurada. El enfoque teórico que soporta el estudio es ecología humana de Luis Carlos Restrepo; se evidencia la existencia de programas transversales, y específicos, en cuanto al dominio de conceptos, los programas de promoción y prevención presentan información necesaria sobre los efectos de las sustancias psicoactivas, fomentan la autoestima, los sentimientos, la autoconciencia personal, las actitudes, creencias y valores; desarrollan habilidades en los estudiantes; entre ellas, habilidades de rechazo, afectivas, cognitivo-conductuales y actividades que formen seres integrales en el hoy y en el ahora.The main purpose of this project is to characterize and prevention programs to promote the use of psychoactive substances implemented in educational institutions ( IE) , which are part of the Units of Local Educational Development ( UDEL ) I through IX of Villavicencio , Meta - Colombia , and observe its structure in terms of domain concepts of being, knowing and doing , as applicable , intensity and methodology . Research is mixed descriptive “seeks to specify the properties, characteristics, and profiles of key individuals, groups, communities or any other phenomenon that is subject to analysis “(Danhke, 1989). Similarly from the Research Action (IA) representing the analysis of reality from experiences of social intervention, in order to “promote social change reality and make people aware of their role in that process transformation” (Sandin, 2003). Intentionally sampled in 60 educational institutions, 55 of which replied to a semi-structured interview was selected. The theoretical approach that supports the study of human ecology Luis Carlos Restrepo ; there is evidence of cross-cutting programs , and specific domain in terms of concepts, promotion programs and prevention present necessary information on the effects of psychoactive substances , build self-esteem , feelings , personal self-awareness , attitudes , beliefs and values; develop skills in students ; including refusal skills , affective , cognitive and behavioral activities that are integral beings in the present and in the now

Propuesta en supply chain management y logística en la empresa chilco distribuidora de gas y energía s.a.s. e.s.p.

Anexo 1. Proveedores Empresa Chilco Distribuidora de Gas y energía S.A.S. E.S.P., Anexo 2. Procedimiento ABA_P001__1__Procedimiento_abastecimiento_de_GLPEl objetivo de este trabajo es desarrollar una propuesta de Supply Chain Management y Logística para la empresa Chilco Distribuidora de Gas y Energía S.A.S. E.S.P. para así poder mejorar cada uno de los procesos claves en el área de almacenamiento, aprovisionamiento, distribución y logística, considerando la gran importancia que tiene aplicar estas estrategias en el mundo moderno, teniendo en cuenta la alta competencia que se mueve actualmente en todo tipo de sectores, haciendo que no solo deba acudirse a estos métodos y estructuras, sino en el mismo instante ir actualizándolos, y llevándolo a un futuro, pues al ser una empresa competitiva lo que es actual ya se hace antiguo, y lo que viene es lo nuevo. En este trabajo se utilizaron técnicas de recolección de datos como cuestionarios y entrevistas a los empleados de la compañía también teniendo en cuenta que uno de los investigadores es empleado en esa compañía Por lo tanto, con este trabajo se pudo concluir que, si bien la compañía aplica muchas de las técnicas aquí encontradas, también tiene algunas falencias que no son graves y aun se encuentra en la vanguardia, pero si en un futuro próximo no se corrigen pueden hacer que la misma pierda ingreso en el sector.The objective of this work is to develop a proposal of Supply Chain Management and Logistics for the company Chilco Distribuidora de Gas y Energía S.A.S. E.S.P. in order to improve each of the key processes in the area of storage, supply, distribution and logistics, considering the great importance of applying these strategies in the modern world, taking into account the high competition that is currently moving in all types of sectors, making it necessary not only to resort to these methods and structures, but at the same time to update them, and taking it to the future, because being a competitive company what is current is already old, and what is coming is the new. In this work, data collection techniques such as questionnaires and interviews with the company's employees were used, also taking into account that one of the researchers is an employee of the company. Therefore, with this work it was possible to conclude that, although the company applies many of the techniques found here, it also has some shortcomings that are not serious and it is still at the forefront, but if they are not corrected in the near future they may cause the company to lose income in the sector

The inverted cup device for blood transfer on malaria RDTs: ease of use, acceptability and safety in routine use by health workers in Nigeria

Abstract Background Malaria rapid diagnostic tests (RDTs) are becoming widely adopted for case management at community level. However, reports and anecdotal observations indicate that the blood transfer step poses a significant challenge to many users. This study sought to evaluate the inverted cup device in the hands of health workers in everyday clinical practice, in comparison with the plastic pipette, and to determine the volume accuracy of the device made of a lower-cost plastic. Methods The volume accuracy of inverted cup devices made of two plastics, PMMA and SBC, was compared by transferring blood 150 times onto filter paper and comparing the blood spot areas with those produced by 20 reference transfers with a calibrated micropipette. The ease of use, safety and acceptability of the inverted cup device and the pipette were evaluated by 50 health workers in Nigeria. Observations were recorded on pre-designed questionnaires, by the health workers themselves and by trained observers. Focus group discussions were also conducted. Results The volume accuracy assessment showed that the device made from the low-cost material (SBC) delivered a more accurate volume (mean 5.4 μL, SD 0.48 μL, range 4.5–7.0 μL) than the PMMA device (mean 5.9 μL, SD 0.48 μL, range 4.9–7.2 μL). The observational evaluation demonstrated that the inverted cup device performed better than the pipette in all aspects, e.g. higher proportions of health workers achieved successful blood collection (96%, vs. 66%), transfer of the required blood volume (90%, vs. 58%), and blood deposit without any loss (95%, vs. 50%). Majority of health workers also considered it’ very easy’ to use (81%),’very appropriate’ for everyday use (78%), and 50% of them reported that it was their preferred BTD. Conclusions The good volume accuracy and high acceptability of the inverted cup device shown in this study, along with observed ease of use and safety in hands of health workers, further strengthens prior findings which demonstrated its higher accuracy as compared with other BTDs in a laboratory setting. Altogether, these studies suggest that the inverted cup device should replace other types of devices for use in day-to-day malaria diagnosis with RDTs.https://deepblue.lib.umich.edu/bitstream/2027.42/140763/1/12936_2018_Article_2173.pd

Farmacovigilancia en Colombia

Se puede decir que la farmacovigilancia es indispensable en la identificación, evaluación, prevención y detección de problemas relacionados con los medicamentos, y es responsabilidad de todos los agentes implicados (pacientes, familiares, clínicas y hospitales, laboratorios farmacéuticos y secretarias de salud) la notificación de dichos reportes. Para la recolección de dicha información la farmacovigilancia cuenta con diferentes métodos, gracias a dichos métodos se puede detectar y notificar: reacciones adversas a los medicamentos (RAM), errores de medicación (EM), problemas relacionados con los medicamentos (PRM) y los problemas relacionados con el uso de los medicamentos (PRUM). Esa información es enviada a la entidad de vigilancia de medicamentos y alimentos INVIMA, con el ánimo de determinar realmente el perfil de seguridad de los medicamentos que son comercializados, generando lineamientos y directrices nacionales que faciliten realizar vigilancia a los medicamentos en la etapa de post- comercialización y sirve para intercambiar y transferir información conocimientos sobre riesgo de sufrir algún evento adverso o cualquier problema relacionado con medicamentos. Es así, nosotros como regentes de Farmacia desempeñamos un papel muy importante en el campo de la Farmacovigilancia, desde el desarrollo de las actividades y procesos del servicio Farmacéutico.It can be said that pharmacovigilance is essential in the identification, evaluation, prevention and detection of problems related to medications, and it is the responsibility of all the agents involved (patients, relatives, clinics and hospitals, pharmaceutical laboratories and health secretaries) to notify of said reports. For the collection of said information, the pharmacovigilance has different methods such as active and passive notification and by epidemiological studies, thanks to these methods it is possible to detect and report: adverse drug reactions (RAM), medication errors (EM), problems drug-related (PRM) and drug- related problems (PRUM). This information is sent to the entity for the surveillance of medicines and foods INVIMA, with the aim of really determining the safety profile of the medicines that are marketed, generating national guidelines and guidelines that facilitate surveillance of medicines at the post-stage. marketing and serves to exchange and transfer knowledge information about the risk of suffering an adverse event or any problem related to medications. This is how we as Pharmacy regents play a very important role in the field of Pharmacovigilance, from the development of the activities and processes of the Pharmaceutical service

LAMP kit for diagnosis of non-falciparum malaria in Plasmodium ovale infected patients

Background: Microscopy and rapid diagnosis tests have a limited sensitivity in diagnosis of malaria by Plasmodium ovale. The LAMP kit (LoopAMP (R)) can be used in the field without special equipment and could have an important role in malaria control programmes in endemic areas and for malaria diagnosis in returned travellers. The performance of the Pan primer of the kit in detecting malaria by P. ovale was compared with the results of standard nPCR in samples of patients returning from P. ovale endemic areas. Methods: Plasmodium ovale positive samples (29, tested by PCR and/or microscopy) and malaria negative specimens (398, tested by microscopy and PCR) were collected in different hospitals of Europe from June 2014 to March 2016 and frozen at -20 degrees C. Boil and spin method was used to extract DNA from all samples and amplification was performed with LoopAMP (R) MALARIA kit (Eiken Chemical, Japan) in an automated turbidimeter (Eiken 500). The results of LAMP read by turbidimetry and with the naked eye were compared. Results: The kit showed a sensitivity of 100% and a specificity of 97.24% with positive and negative predictive values of 72.5 and 100%, respectively. Naked eyed readings were in accordance with turbidimetry readings (sensitivity, 92.5%, specificity, 98.96% and positive and negative predictive values, respectively, 90.24 and 99.22%). The limit of detection of LAMP assay for P. ovale was between 0.8 and 2 parasites/mu l. Conclusions: The Pan primer of the Malaria kit LoopAMP (R) can detect P. ovale at very low-levels and showed a predictive negative value of 100%. This tool can be useful in malaria control and elimination programmes and in returned travellers from P. ovale endemic areas. Naked eye readings are equivalent to automated turbidimeter readings in specimens obtained with EDTA.Peer reviewe

Prototype positive control wells for malaria rapid diagnostic tests: Prospective evaluation of implementation among health workers in Lao People's Democratic Republic and Uganda

Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis, but lack of quality control at point of care restricts trust in test results. Prototype positive control wells (PCW) containing recombinant malaria antigens have been developed to identify poor-quality RDT lots. This study assessed community and facility health workers' (HW) ability to use PCWs to detect degraded RDTs, the impact of PCW availability on RDT use and prescribing, and preferred strategies for implementation in Lao People's Democratic Republic (Laos) and Uganda. A total of 557 HWs participated in Laos (267) and Uganda (290). After training, most (88% to ≥ 99%) participants correctly performed the six key individual PCW steps; performance was generally maintained during the 6-month study period. Nearly all (97%) reported a correct action based on PCW use at routine work sites. In Uganda, where data for 127,775 individual patients were available, PCW introduction in health facilities was followed by a decrease in antimalarial prescribing for RDT-negative patients ≥ 5 years of age (4.7–1.9%); among community-based HWs, the decrease was 12.2% (P < 0.05) for all patients. Qualitative data revealed PCWs as a way to confirm RDT quality and restore confidence in RDT results. HWs in malaria-endemic areas are able to use prototype PCWs for quality control of malaria RDTs. PCW availability can improve HWs' confidence in RDT results, and benefit malaria diagnostic programs. Lessons learned from this study may be valuable for introduction of other point-of-care diagnostic and quality-control tools. Future work should evaluate longer term impacts of PCWs on patient management

Towards a Microplastic-Free Ocean: Green Photocatalysis for Mitigation of Micro- and Nanoplastic Marine Pollution

The presence of microplastics (MPs) or nanoplastics (NPs) in the ocean is one of our society's most pressing environmental issues. MPs and NPs cause health issues to the biota that consumes them and are being transferred throughout the tropic chain up to humans. Since MPs and NPs are first produced in upstream processes, reducing MPs inputs through management before introducing them to aquatic ecosystems is the best option to protect the ocean. Photocatalysis is a water treatment process that can achieve this goal. In this research, visible light photocatalysis in aqueous medium of polyethylene (PE), polystyrene (PS) and polyethylene terephthalate (PET) MPs and NPs was investigated using N-TiO2, C,N-TiO2 and C,N-TiO2/SiO2. The influence of pH, temperature, MPs' size and the semiconductor's form (powders or films) on the removal process was tested. All the variables influenced degradation and photocatalysis can reach in some cases 70% of MPs removal in 50 h of reaction. This information can guide the design of photocatalytic systems that reduce MPs pollution