Additional file 1: Table S1. of Patient satisfaction with a teleradiology service in general practice

Patient satisfaction questions. Table S2. Mirror Questions. Table S3. Patients’ perceptions and expectations. Table S4. Results patient satisfaction questions. Table S5. Results: Patients’ perceptions and expectations. (DOCX 24 kb

A Systematic Review and Meta-Analysis of the Performance of Two Point of Care Typhoid Fever Tests, Tubex TF and Typhidot, in Endemic Countries

<div><p>Background</p><p>In the absence of well-equipped laboratory infrastructure in many developing countries the accurate diagnosis of typhoid fever is challenging. Rapid diagnostic tests (RDT) with good performance indicators would be helpful to improve clinical management of suspected cases. We performed a systematic literature review and meta- analysis to determine the performance of TUBEX TF and Typhidot for the diagnosis of typhoid fever using PRISMA guidelines.</p><p>Methods</p><p>Titles and abstracts were reviewed for relevance. Articles were screened for language, reference method and completeness. Studies were categorized according to control groups used. Meta-analysis was performed only for categories where enough data was available to combine sensitivity and specificity estimates. Sub-analysis was performed for the Typhidot test to determine the influence of indeterminate results on test performance.</p><p>Results</p><p>A total of seven studies per test were included. The sensitivity of TUBEX TF ranged between 56% and 95%, Specificity between 72% and 95%. Meta-analysis showed an average sensitivity of 69% (95%CI: 45–85) and an average specificity of 88% (CI95%:83–91). A formal meta-analysis for Typhidot was not possible due to limited data available. Across the extracted studies, sensitivity and specificity estimates ranged from 56% to 84% and 31% to 97% respectively.</p><p>Conclusion</p><p>The observed performance does not support the use of either rapid diagnostic test exclusively as the basis for diagnosis and treatment. There is a need to develop an RDT for typhoid fever that has a performance level comparable to malaria RDTs.</p></div

Forest Plot for Tubex TF with different control groups.

<p>Forest Plot for Tubex TF with different control groups.</p

Palladium(II)-Catalyzed Synthesis of 2<i>H</i>,3′<i>H</i>‑Spiro[benzofuran-3,2′-naphthoquinones]

2<i>H</i>,3′<i>H</i>-Spiro­[benzofuran-3,2′-naphthoquinones], constituting a new spiroheterocyclic skeleton, were synthesized starting from 2-aryloxymethyl-1,4-naphthoquinones by means of a palladium­(II)-catalyzed reaction, which is a new spirocyclic transformation. Under optimal conditions, i.e. 10 mol % of palladium­(II) acetate, 15 mol % of 3,5-dichloropyridine, and 5 mol % of trifluoroacetic acid in acetic acid at 110 °C, various 2<i>H</i>,3′<i>H</i>-spiro­[benzofuran-3,2′-naphthoquinones] were synthesized in yields strongly dependent on the substitution pattern of the aryloxy group. Unsubstituted or <i>ortho</i>-substituted 2-aryloxymethyl-1,4-quinones were found to rearrange toward the corresponding 2-(4-hydroxyaryl)-1,4-quinones upon treatment with trifluoroacetic acid

Sensitivity and specificity estimates for Tubex TF (open squares) with control group category 1 together with average sensitivity and specificity estimate (filled circle) and 95% confidence region.

<p>Sensitivity and specificity estimates for Tubex TF (open squares) with control group category 1 together with average sensitivity and specificity estimate (filled circle) and 95% confidence region.</p

Sensitivity (Sens.), Specificity (Spec.) and Accuracy (Acc.) of Typhidot depending on definition of indeterminate results (only studies included where information on indeterminate results are available).

<p>*category 1 – samples with known etiology other than <i>Salmonella</i> Typhi; category 2 – samples with unknown etiology (blood culture negative); category 3 – a combination of category 1 and 2.</p

Overview Typhidot studies.

<p>Overview Typhidot studies.</p

Test characteristics of the different RDT products.

<p>PD = parasite density, Pf = <i>P. falciparum</i>, Pv = <i>P. vivax</i>, Po = <i>P. ovale</i>, Pm = <i>P. malariae.</i></p>*<p>including one P. vivax sample that generated a strong positive result upon testing PfHRP2 ELISA.</p>†<p>one sample missed with parasite density 2,458/µl.</p>‡<p>including one invalid result. § including one missed sample with parasite density 3,251/µl.</p

Presence of important items that need to be addressed in the instructions for use.

<p>N.A. = not applicable.</p>*<p>The user is advised to take the treatment included in the kit.</p>†<p>Repeating the test after 12 hours is advised, independent of persistence of symptoms.</p>‡<p>The user is advised to use the ‘pan’ line for treatment follow-up.</p

Overview of RDT products and their lot numbers.

<p>PfHRP2 =  <i>P. falciparum</i> Histidine-rich protein-2; pan-pLDH = pan <i>Plasmodium</i> lactate dehydrogenase; Pf-pLDH = <i>P. falciparum</i>-pLDH.</p>*<p>Websites last accessed on 07-08-2012.</p>†<p>Target antigens not specified.</p>‡<p>On the website a CE label was displayed but not on the delivered products.</p