Drop Of Blood Research Articles

High frequency of artemisinin partial resistance mutations in the Great Lakes region revealed through rapid pooled deep sequencing.

In Africa, the first Plasmodium falciparum artemisinin partial resistance mutation, was Kelch13 (K13) 561H - detected and validated at appreciable frequency in Rwanda in 2014. Surveillance to better define the extent of the emergence in Rwanda and neighboring countries is critical. We used novel liquid blood drop preservation combined with pooled sequencing to provide cost-effective rapid assessment of resistance mutation frequencies at multiple collection sites across Rwanda and neighboring regions in Uganda, Tanzania, and the Democratic Republic of the Congo (DRC). Malaria-positive samples (n=5,465) from 39 health facilities collected between May 2022 and March 2023 were sequenced in 199 pools. In Rwanda, K13 561H and 675V were detected in 90% and 65% of sites with an average frequency of 19.0% (0-54.5%) and 5.0% (0-35.5%), respectively. In Tanzania, 561H had high frequency in multiple sites. 561H appeared at 1.6% in Uganda. 561H was absent from the DRC, although 675V was seen at low frequency. Concerningly candidate mutations were observed: 441L, 449A, and 469F co-occurred with validated mutations suggesting they are arising under the same pressures. Other markers for decreased susceptibility to artemether-lumefantrine are common: P. falciparum multidrug resistance protein 1 N86 at 98.0% (63.3-100%) and 184F at 47.0% (0-94.3%) and P. falciparum chloroquine resistance transporter 76T at 14.7% (0-58.6%). Additionally, sulfadoxine-pyrimethamine-associated mutations show high frequencies. K13 mutations are rapidly expanding in the region further endangering control efforts with the potential of engendering partner drug resistance.

A-155 Development of drop-of-blood QATT heparinase and functional fibrinogen assays

Abstract Background Monitoring the blood coagulation status of patients with coagulopathy or on anticoagulant therapy is important for informed treatment decisions. Quasi-static acoustic tweezing thromboelastometry (QATT) can monitor changes in blood coagulation using a small blood drop. Here, we develop the heparinase and functional fibrinogen QATT assays. Methods Citrated whole blood (WB) samples were collected from 20 healthy volunteers using IRB-approved protocols No. 520566 and 944474. Half of the samples were used for fibrinogen, platelet count tests and the others were used for QATT measurements. For developing heparinase assay, WB samples from 4 healthy volunteers were randomly selected. For each volunteer sample, QATT experiments were performed for a WB sample, a WB sample spiked with 0.5 IU/mL heparin, and a WB sample spiked with heparin and then heparinase. For developing functional fibrinogen assay, QATT experiments were performed for a WB sample and a WB sample spiked with Cytochalasin-D (4 μM). Coagulation was triggered via intrinsic pathway. Pearson correlation coefficient (rp) or the Spearman rank correlation coefficient (rs) was used for correlation analysis. We focused on the following QATT parameters: CIT, MCF, and MCE. Results The heparinase assay effectively reversed heparinized samples (Fig. 1a). CIT of normal and heparinized samples treated with heparinase were within reference range (Fig. 1b). The effect of Cytochalasin-D was shown in Fig 1c. Strong correlation was found between MCE of Cyto-treated WB and fibrinogen level (rp = 0.75). MCE of the difference between normal and Cyto-treated WB, referred to as MCEplatelet, was also strongly correlated with platelet count test (rs = 0.76). The normal range for MCF of the functional fibrinogen assay is efficient in ruling out abnormal fibrinogen level (Fig. 1d). Conclusions QATT accurately predicted the inhibition of heparin by heparinase. QATT functional fibrinogen assay detected the contribution of both fibrinogen and platelets to the clot strength.

Usability study of the qLabs® FIB: A new point-of-care system for functional fibrinogen testing

BackgroundIdentification of hypofibrinogenemia is particularly important in obstetrics since this predicts progression to severe Post-Partum Haemorrhage (PPH). ObjectivesTo evaluate the usability of qLabs® FIB at the bedside of patients with PPH. MethodsThe qLabs® FIB test was performed using a drop of whole blood from a citrated laboratory tube sampled from each parturient with PPH >1 L by a trained user. A usability survey was completed by each clinician performing the test. ResultsDuring the evaluation, 101 qLabs® FIB tests were performed. One hundred completed surveys and 58 free comments were collected. Satisfaction was achieved in 84 % of tests. Usability in emergency setting, timeliness of results, and the results display were considered positive. The qLabs® FIB results were obtained in <3 min for concentrations below 3 g/L whilst the median time to paired laboratory results was 60 (20–120) minutes. The lower a patient's fibrinogen level, the faster the qLabs® FIB result. ConclusionThe usability study was the first step in the validation process of the qLabs® FIB point of care device in obstetric settings.

Multiple oxidative modifications on hemoglobin are elevated in breast cancer patients as measured by nanoflow liquid chromatography-tandem mass spectrometry

Breast cancer is strongly connected with elevated oxidative stress. Oxidative modifications of hemoglobin can serve as biomarkers for monitoring oxidative stress status in vivo. The structure of hemoglobin modifications derived from malondialdehyde (MDA) in human blood hemoglobin exists as N-propenal and dihydropyridine (DHP). This study reports the simultaneous quantification of eleven modified peptides in hemoglobin derived from MDA and advanced histidine oxidation in 16 breast cancer patients and 16 healthy women using nanoflow liquid chromatography nanoelectrospray ionization tandem mass spectrometry. The results reveal statistically significant increases in the formation of MDA-derived N-propenal and DHP of lysine and advanced oxidation of histidine in hemoglobin of breast cancer patients with the Mann-Whitney U-test p values < 0.0001 and the AUC of ROC between 0.9277 and 1.0. Furthermore, the elevation in modified peptides is significant in patients with early stages of breast cancer. By measuring these oxidative modifications in hemoglobin from a drop of blood, the role of lipid peroxidation and oxidative stress in breast cancer can be assessed using this sensitive assay.

The Association of Dietary Micronutrient Intake and Systemic Inflammation among Patients with Type 2 Diabetes: A Cross-Sectional Study.

Inflammation contributes to the pathogenesis of type 2 diabetes (T2DM). This study sought to document how the systemic biomarkers of inflammation varied based on food choices among patients with T2DM. This cross-sectional study enrolled ambulatory patients with T2DM. Demographic and clinical information was collected. Five drops of fingerstick blood were collected using an absorbent paper device (HemaSpot HFR). C-reactive protein (CRP), serum amyloid A protein (SAA), and fibrinogen were measured using a Luminex assay. Patient-generated 7-day food diaries were analyzed using a validated food processor software. Data were analyzed by Pearson's correlation tests, linear regression and logistic regression with the significance level set at 0.05. Among the 71 participants, 43 (60.6%) were females. The average age and duration of T2DM were 64.1 ± 10.3 and 15.8 ± 9.1 years, respectively. In a simple linear regression run with selected micronutrients, iron [F (1, 53) = 5.319, p < 0.05, adj. R2 = 0.074] significantly predicted plasma CRP. This significance was lost with multiple linear regressions including age, gender, BMI, T2DM duration, T2DM complications, glycohemoglobin A1c (HbA1c) and other micronutrients. The average intake of most micronutrients by the participants was below the recommended daily intake. A higher intake of iron-rich foods was associated with higher levels of systemic inflammation in a simple linear regression model, but the association was not present after adjusting for patient factors like age, gender, BMI and T2DM-related variables. This relationship needs to be explored further given the key role of inflammation in the pathogenesis of T2DM and its associated complications.

The Flip and Fix internal limiting flap technique versus the classic temporal flap for macular hole repair.

To describe a novel technique of macular hole (MH) repair and compare it to the perfluorocarbon liquid (PFCL)-assisted temporal internal limiting membrane (ILM) flap technique. Twenty-two eyes of 22 patients with MH were randomized on a 1:1 basis into two groups. Group A cases were treated using the Flip and Fix technique, in which the single-layer ILM flap was flipped, flattened over the macula using PFCL, and fixed in place using two drops of autologous nonheparinized blood over the superonasal and inferonasal edges of the flap (away from the MH center). Group B patients had the classic temporal ILM flap technique without using the PFCL or autologous blood. All patients were followed up for a period of 6 months after the surgery. No significant difference was observed in initial and final visual acuities between Groups A and B. Intraoperative flap displacement did not occur in Group A and occurred in two eyes in Group B (18.2%). One of them showed failed MH closure and required reoperation. These two cases had a final (W shape) MH closure and a worse final vision than the remaining cases, which had either a U shape or V shape final MH closure. The study results show that the Flip and Fix technique is as effective as the PFCL-assisted temporal ILM flap technique and is associated with less ILM flap displacement risk for the repair of macular holes.

Multi-Biomarker Profiling for Precision Diagnosis of Lung Cancer.

Multi-biomarker analysis can enhance the accuracy of the single-biomarker analysis by reducing the errors caused by genetic and environmental differences. For this reason, multi-biomarker analysis shows higher accuracy in early and precision diagnosis. However, conventional analysis methods have limitations for multi-biomarker analysis because of their long pre-processing times, inconsistent results, and large sample requirements. To solve these, a fast and accurate precision diagnostic method is introduced for lung cancer by multi-biomarker profiling using a single drop of blood. For this, surface-enhanced Raman spectroscopic immunoassay (SERSIA) is employed for the accurate, quick, and reliable quantification of biomarkers. Then, it is checked the statistical relation of the multi-biomarkers to differentiate between healthy controls and lung cancer patients. This approach has proven effective; with 20µL of blood serum, lung cancer is diagnosed with 92% accuracy. It also accurately identifies the type and stage of cancer with 87% and 85%, respectively. These results show the importance of multi-biomarker analysis in overcoming the challenges posed by single-biomarker diagnostics. Furthermore, it markedly improves multi-biomarker-based analysis methods, illustrating its important impact on clinical diagnostics.

Clinical metabolomics: current state and prospects in Russia.

Using analytical technologies it is possible now to measure the entire diversity of molecules even in a small amount of biological samples. Metabolomic technologies simultaneously analyze thousands of low-molecular substances in a single drop of blood. Such analytical performance opens new possibilities for clinical laboratory diagnostics, still relying on the measurement of only a limited number of clinically significant substances. However, there are objective difficulties hampering introduction of metabolomics into clinical practice. The Institute of Biomedical Chemistry (IBMC), consolidating the efforts of leading scientific and medical organizations, has achieved success in this area by developing a clinical blood metabogram (CBM). CBM opens opportunities to obtain overview on the state of the body with the detailed individual metabolic characteristics of the patient. A number of scientific studies have shown that the CBM is an effective tool for monitoring the state of the body, and based on the CBM patterns (signatures), it is possible to diagnose and monitor the treatment of many diseases. Today, the CBM creation determines the current state and prospects of clinical metabolomics in Russia. This article, dedicated to the 80th anniversary of IBMC, is a review of these achievements focused on a discussion of their implementation in clinical practice.

Correlation between the prothrombin time values obtained by point-of care prothrombin time meter and clinical laboratory in paediatric intensive care unit of a developing country

Background: Monitoring of prothrombin time (PT) is essential for adequate management of children in pediatric intensive care unit (PICU) who require serial and repeated PT measurements. In contrast to laboratory testing, point-of-care (POC) PT meters have been configured especially for bedside that are cost effective with rapid turnaround time. Our study aimed to assess its feasibility for routine use in PICU by assessing the correlation between PT values obtained through the POC PT meter and those acquired from the laboratory. Methods: A total of 200 children of either gender aged between 1 month to 12 years, admitted to PICU of Indus hospital Karachi Pakistan from February to August 2023 were analysed in this cross-sectional study. Venous blood samples were collected in PT bottles and transported to the pathology department within a time frame of 20-30 minutes for analysis. Concurrently, a drop of blood was obtained via finger prick and promptly assessed using the POC device-Coaguchek INRange system, (Roche diagnostics Ltd, USA). Pearson’s correlation was applied. Results: 200 children (96 males, 104 females) having a mean age of 6.42±3.55 years. The mean PT values with POC meter and Laboratory were 2.588±1.299 and 2.574±1.304 respectively (p=0.100). Very strong correlation of PT between POC PT meter and laboratory evaluation was observed (r=0.996, p&lt;0.001). Conclusions: The strong correlation observed between POC PT meter and laboratory supports the use of these devices for timely coagulation monitoring, potentially improving patient outcomes in PICUs.

Comparative Evaluation of Pfeiffer’s Blood Crystallization Test for Early Detection of Epithelial Dysplasia in OSMF and Healthy Individuals: A Cross-Sectional Study

Background: Unlike other malignancies, oral cancer is preceded by Oral Potentially Malignant Disorders (OPMDs). Oral Submucous Fibrosis (OSMF) is one such OPMD with malignant potential of 7.6%. The purpose of present study was to determine the efficacy of Pfeiffer’s blood Crystallization test for early detection of epithelia dysplasia in OSMF individuals. Material and methods: The study participants included were involved 50 OSMF subjects and 50 healthy controls. The blood drop collected was subjected to crystallization test and the crystal patterns formed were analyzed after 20 hours. Incisional biopsy was performed in OSMF subjects to grade the degree of epithelial dysplasia. The data obtained was subjected to statistical analysis. Results: The participant’s age in the study groups ranged up to 56 years. Difference in the crystallization pattern between diseased group and non-diseased group was significant (p-value &lt; 0.05%) with more transverse pattern in diseased group. The OSMF participants with no epithelial dysplasia showed normal crystallization pattern and maximum participants with dysplasia showed transverse pattern and the difference was statistically significant (p-value&lt;0.05%). The sensitivity and specificity of crystallization test for OSMF was found to be 91.4% and 100.0% respectively. Conclusion: Pfeiffer's Crystallization test can be considered as a less invasive and reliable screening aid for OSMF which helps clinicians to identify high‑risk individuals for malignant transformation.

Three-dimensional microfluidic paper-based analytical device fabricated by cutting technique for highly sensitive and specific colorimetric detection of triglycerides in whole blood utilizing a mixed indicator system

In this study, we developed a three-dimensional microfluidic paper-based analytical device (3D-µPAD) for quantifying triglycerides (TGs) in whole blood samples. This method provides an alternative to conventional TGs detection and offers several advantages. The 3D-µPAD was fabricated using an in-house computer-controlled X-Y knife plotter, eliminating the need for hydrophobic reagents. This approach results in a more rapid, simple, highly reproducible, and cost-effective mass production process. To separate plasma from a drop of whole blood, the LF1 membrane was incorporated as a sample zone on the 3D-µPAD. The hydrolysis of TGs was catalyzed by lipase, producing H+ ions detected by a phenol red indicator read against cyan ink to reduce background interference. A spectrophotometer (i1 Pro 3 mini) measured the green color intensity in the 3D-µPAD’s detection zone, which was proportional to the TGs concentration and quantified within 10 min. Results were consistent with clinical methods, with a detection limit of 0.182 mmol L−1 in the 0.1–6 mmol L 0207B1 TGs concentration range. Using mixed indicators successfully reduced background interference and enhanced sensitivity for TGs determination. The 3D-µPAD demonstrated a storage stability of approximately 30 days. Our 3D-µPAD prototype offers a rapid, cost-effective, and user-friendly approach for pre-clinical TGs diagnostics, expanding the potential for point of care whole blood sample analysis.

Assess human blood uranium levels of some Iraqi companies

The goal of this study is to measure the uranium concentration levels in the blood of Iraqi workers employed in certain government companies. Assessing the initial level of uranium toxicity in their blood and the possibility of health problems occurring. 184 blood samples from Iraqi government companies and the control group were collected in this study. A solid-state nuclear track detector (CR-39) was used to measure the amount of uranium present. Two drops of blood (100 μl) were placed on CR-39. The CR-39 was irradiated with a thermal neutron using the fission-track technique (241Am-9Be) to determine the uranium concentration in blood samples. The statistical analysis is carried out using the Origin Lab 2024 version. The results show the average of uranium concentration at all locations has a higher level compared to the control group. The blood samples from workers at the phosphate company had the highest amount (1.021 ± 0.050 μg/l), compared to samples from other factories. This result confirms that there is a connection between the concentration of uranium and phosphate substances. The results suggest that there is a slight increase in uranium levels that is related to both age and years of employment.

First Report on Clinical Feasibility of Dried Blood Spot Technique for Hemoglobin Estimation in Cholistani Cattle

Background: The dried blood spot (DBS) technique using filter papers has revolutionized the conventional blood sampling techniques through ease of blood collection, storage and transport. Various analytes (such as hormones, antigens, antibodies and hematochemical attributes) are being estimated through DBS globally. However, this technique has not yet been implied in Pakistan. This research work is the first of its kind regarding hemoglobin (Hb) estimation in Cholistani cattle (n=63) blood through DBS technique using filter paper.Methods: Three methods of Hb estimation were implied in the present study viz. through veterinary hematology analyzer (HbA), and two indirect cyanmethemoglobin methods (HbIC and HbICX) using measured (20µL) and unmeasured blood drops on the filter paper, respectively.Results: Results revealed that HbA and HbIC were non-significantly (P≥0.05) different from each other, being different from HbICX (P≤0.05). The HbICX gave overestimated values of Hb as compared to HbA and HbIC. The sensitivity, specificity, positive predictive value, and negative predictive value for HbIC were higher being 86.1%, 88.3%, 88.0%, and 86.0%, respectively as compared to the lower values of 45.0%, 12.0%, 12.0% and 45.0%, for HbICX. Bland and Altman test revealed a better level of agreement between HbA and HbIC. Around the mean difference line, there was no proportional bias in data distribution (Mean= -0.16, 95% CI= 0.34 to -0.67). Similarly, measures attained through Cronbach alpha and intraclass correlation coefficient between HbA and HbIC were higher being 0.703 and 0.825 values for single and average, respectively, as compared to the values of 0.200 and 0.333 between HbA and HbICX.Conclusion: It is concluded that the indirect cyanmethemoglobin method for Hb estimation is reliable and accurate for cattle blood, if a measured quantity of blood drop is taken on a filter paper. We recommend this DBS technique for Hb estimation in cattle blood for resource-poor settings and for livestock herds being reared distantly from the laboratories. For future, it is recommended that DBS technique with various other modifications and for other hematochemical biomarkers may be validated for livestock blood.Keywords: Dried blood spot; Hemoglobin; Cholistani cattle

Transforming Renal Diagnosis: Graphene‐Enhanced Lab‐On‐a‐Chip for Multiplexed Kidney Biomarker Detection in Capillary Blood

AbstractChronic kidney disease (CKD) is a significant global health concern, impacting over 10% of the world population. Despite advances in home‐based treatments, CKD diagnosis and monitoring remain centralized in large laboratories. This work reports on the development of a Graphene‐based Lab‐On‐a‐Chip (G‐LOC) for the self‐testing of multiple renal function biomarkers in capillary blood. G‐LOC integrates bioelectronic sensors with a 3D‐printed microfluidic system that enables the multiplex quantification of urea, potassium, sodium, and chloride, from one drop of blood. The potentials of three graphene sensors modified with ion‐selective membranes and enzymes are simultaneously measured. The analytical performance of the test is evaluated in terms of linearity, accuracy, and coefficient of variability (CV). Accuracy values higher than 98.7%, and CV values lower than 10.8% are obtained for all the biomarkers. Correlation and Bland–Altman plots show good correlation (slopes in the range of 0.94–1.15) and high agreement of G‐LOC with a reference method. It is also demonstrated that the test can correctly differentiate biomarker levels normally obtained for healthy people, early‐stage CKD, and end‐stage CKD. Finally, user experience is studied with a group of untrained volunteers who highlight the simple usability of the test and its suitability for at‐home diagnostics.

Audit à propos des connaissances du personnel soignant en matière de la transfusion : étude multicentrique

Transfusion is an important question of daily clinical practice. Transfusion is governed by rigorous security rules. To assess the knowledge of healthcare personnel regarding transfusion. This descriptive study was carried out by an anonymous survey, with anaesthetist resident, surgery resident, interns, anaesthetist, and nurses. This study was from January 1 to February 29, 2020. It was approved by the local ethics committee. We included 196 participants. 94.9% knew that red blood cells must be stored in the refrigerator. 58.2% thought that red blood cells should be transfused within 30 minutes of warming, and 31.6% said it should be transfused within 3 hours. We found that 85% knew that fresh frozen plasma should be stored in the freeze, and 59.7% said that the frozen plasma should be thawed within 30 minutes at most and 38.3% thought that the thawing should take at least one hour. Regarding the pretransfusion bedside test, 84.4% knew that it must be done by two personnel one of whom must be a doctor. 40.8% thought that the test consists of mix a drop of patient blood and a drop of bag blood. Several insufficiencies were found. There is a necessity of launching periodic training courses focusing on the management of blood products and the transfusion procedure.

Kritik Sosial Dalam Lirik Lagu (Analisis Wacana Lagu Maju Dari .Feast)

Feast is a band that expresses social criticism through songs. Idealism in music, the use of words that contain figures of speech, and the themes presented make the author use the lyrics of the song "Maju" by the band .Feast as a study in this research. The method used in this research is qualitative method. The aim of this research is to find out the meaning of social criticism in the song "Maju" using Teun A. Van Dijk's approach. Critical discourse analysis using Teun A. van Dijk's approach model includes text dimensions, social cognition dimensions, and social context dimensions. The text dimension will analyze macro structure, superstructure and micro structure, then discuss it in the social cognition dimension and social context dimension to find the meaning of social criticism in the lyrics of the song "Maju". Analysis of song lyric data was carried out to describe the meaning of social criticism in the lyrics of the song "Maju" by .Feast. The results of this research show that there is social criticism in the lyrics of the song "Maju" sung by . survive and fight to the last drop of blood to defend the sovereignty of the Republic of Indonesia. Courage is something that must be instilled in every human being and defending the rights that belong to us is a must.

Place-making Beyond Humans: Environmental Photography with Dots

Thinking with the environmental photography collection on her Instagram account, the author of this visual essay focuses on a conceptual exploration of dots and their agential capacity. From COVID-19-shot blood drops, egg cells, and black fly bites to human irises as devices unlocking phones–all images are unique re-presentations of a posthuman, non-anthropocentric fabric, constantly shaping and reshaping territory. Dots prompt the question: Who contributes to this place besides humans? The author concludes with a discussion on how, in times of climate change, the conceptual insights of the blog can be applied in environmental art education through her place-responsive practice.

Determination of angle of impact and directionality of drip stains on various fabrics

Bloodstain pattern analysis (BPA) on absorbent surfaces, such as fabrics, is far more complex compared to its application on smooth, hard, non-porous surfaces. Angle of impact and directionality are commonly interpreted from bloodstains but may be adversely affected by porous surfaces. In fact, there is a lack of evidence that traditional approaches to BPA are even applicable when blood impacts absorbent materials such as clothing and other fabrics. Hence, there is a critical need for research focusing on the validity and reliability of methods for bloodstain pattern analysis on textiles. Here, human blood drops were deposited on six different fabric types (cotton, satin polyester, rayon, blended polyester/spandex, blended nylon/spandex, and blended modal/polyester/spandex) at two known impact angles: 30° and 10°. Bloodstain morphology was found to be unique for each fabric. Calculated angles of impact for cotton and satin polyester were not statistically different from the known angle of impact while blended polyester/spandex, blended nylon/spandex, and blended modal/polyester/spandex significantly underestimated the known angle of impact. Even when stain morphology on fabric resembled those on a glass control, the angle of impact significantly underestimated the known. The ability to assign directionality based upon bloodstain morphology was dependent on the fabric type. These findings support the need for further research and the development of guidelines for bloodstain pattern interpretation on fabric materials.

#3096 Exploratory population-based screening of kidney function and heavy metal water source levels in a highly incident CKDu area in Guatemala

Abstract Background and Aims Chronic kidney disease of unknown etiology (CKDu) has exponentially increased in the rural areas of the Pacific Coast in Central America. A multifactorial etiology has been postulated including exposure to environmental nephrotoxins such as heavy metals. The Pacific Coast of Guatemala has a volcanic topography with a high content of heavy metals, and the rural communities use ground water as their regular drinking consumption. Since the highest age group affected by CKDu are young adults, we postulated an exposure during childhood impacting later in life. We aim to identify changes in kidney function in children and adolescent healthy population from a highly incident CKDu area, and the heavy metal levels from water sources as a hypothesis generation exploratory study. Method We performed a population-based cross-sectional study of children and adolescents (below 17 y/o) from La Democracia municipality that were randomly chosen using Epidat software 3.1 from 10 different local schools from March 2019 to March 2020. The study was approved by external ethics board committee external-independent research ethics board committee. Subjects were excluded if they had known diagnosis of CKD, kidney replacement therapy or hypertension. The screening was performed in three different steps including a background assessment questionnaire, clinical assessment, and biochemical testing including creatinine from blood drop using StatSensor XpressTM to calculate estimated glomerular filtration rate (eGFR), urine dipstick, urinary creatinine, and protein. We measured arsenic (33As), cadmium (48Cd), mercury (80Hg), and lead (82Pb) in 21 water wells around the 10 screened schools, while only arsenic (33As), cadmium (48Cd) and mercury (80Hg) were measured in the urine of a small subset of the samples (data not shown in the results). Results A total of 508 randomly selected subjects’ and parents’ consent for screening but only 506 completed assessment. The median age was 14 y/o (IQR 11-17) 50% being female, with a close to 30% of the sample having obesity. The blood pressure was abnormal in 28% of the sample and at least 30% of them had an abnormal urine dipstick. The overall eGFR was 98, being the 25th%tile close to 83 ml/min/1.73 m2 BSA (Tables 1 and 2). Water sources showed higher than recommended levels of all heavy metals tested. Interestingly, the schools “Campiña” showed high levels of Arsenic and Cadmium in water sources, being the subjects tested coincidentally among the lowest eGFR of sample. Conclusion CKDu is an entity devastating low-resourced communities with young adults being the most affected. A likelihood for a link of early exposure needs to be further explored. Addressing the postulated hypothesis are key to implement preventive strategies, including screening earlier in life such as pediatric population.

Sub-microscopic Plasmodium falciparum infections and multiple drug resistant single nucleotide polymorphic alleles in pregnant women from southwestern Nigeria

ObjectivesThe study evaluated sub-microscopic malaria infections in pregnancy using two malaria Rapid Diagnostic Tests (mRDTs), microscopy and RT-PCR and characterized Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and Plasmodium falciparum dihydropteroate synthase (Pfdhps) drug resistant markers in positive samples.MethodsThis was a cross sectional survey of 121 pregnant women. Participants were finger pricked, blood drops were collected for rapid diagnosis with P. falciparum histidine-rich protein 11 rapid diagnostic test kit and the ultra-sensitive Alere Pf malaria RDT, Blood smears for microscopy and dried blood spots on Whatman filter paper for molecular analysis were made. Real time PCR targeting the var acidic terminal sequence (varATS) gene of P. falciparum was carried out on a CFX 96 real time system thermocycler (BioRad) in discriminating malaria infections. For each run, laboratory strain of P. falciparum 3D7 and nuclease free water were used as positive and negative controls respectively. Additionally, High resolution melt analyses was employed for genotyping of the different drug resistance markers.ResultsOut of one hundred and twenty-one pregnant women sampled, the SD Bioline™ Malaria Ag P.f HRP2-based malaria rapid diagnostic test (mRDT) detected eight (0.06%) cases, the ultra-sensitive Alere™ malaria Ag P.f rapid diagnostic test mRDT had similar outcome in the same samples as detected by the HRP2-based mRDT. Microscopy and RT-PCR confirmed four out of the eight infections detected by both rapid diagnostic tests as true positive and RT-PCR further detected three false negative samples by the two mRDTs providing a sub-microscopic malaria prevalence of 3.3%. Single nucleotide polymorphism in Pfdhps gene associated with sulphadoxine resistance revealed the presence of S613 mutant genotypes in three of the seven positive isolates and isolates with mixed wild/mutant genotype at codon A613S. Furthermore, four mixed genotypes at the A581G codon were also recorded while the other Pfdhps codons (A436G, A437G and K540E) showed the presence of wild type alleles. In the Pfdhfr gene, there were mutations in 28.6%, 28.6%, and 85.7% at the I51, R59 and N108 codons respectively. Mixed wild and mutant type genotypes were also observed in 28.6% each of the N51I, and C59R codons. For the Pfcrt, two haplotypes CVMNK and CVIET were observed. The SVMNT was altogether absent. Triple mutant CVIET 1(14.3%) and triple mutant + wild genotype CVIET + CVMNK 1(14.3%) were observed. The Pfmdr1 haplotypes were single mutants YYND 1(14.3%); NFND 1(14.3%) and double mutants YFND 4(57.1%); YYDD 1(14.3%).