Cassette Test Research Articles

Examination of Diagnostic Performance of New IgG4 Rapid Test Compared with IgG- and IgG4-ELISAs to Investigate Epidemiology of Strongyloidiasis in Northeast Thailand.

Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised individuals, and accurate diagnosis leading to timely treatment can save lives. Serodiagnosis is a sensitive method for diagnosis and is recommended for screening high-risk individuals. A point-of-care rapid test will facilitate the screening activities, especially in low-resource settings. This study aims to apply a new IgG4 immunochromatographic test using S. stercoralis recombinant antigen (SsRapid® cassette test) and to compare it with in-house IgG and IgG4 enzyme-linked immunosorbent assays (IgG- and IgG4-ELISAs) using native Strongyloides ratti antigen to investigate the epidemiology of strongyloidiasis in northeast Thailand. A total of 300 people participated, with 136 males and 164 females of a similar mean age. The reference tests were fecal examinations using the formalin-ethyl acetate concentration technique and an agar plate culture technique. The prevalence of S. stercoralis determined by SsRapid (81.7%) was significantly higher than that by fecal examinations (43.3%) or by antibody detection by IgG-ELISA (53.0%) or IgG4-ELISA (44.0%). The diagnostic sensitivities of SsRapid, IgG-ELISA, and IgG4-ELISA were found to be 93.9%, 77.7%, and 63.1%, respectively. The rate of positive tests by the SsRapid was significantly correlated to the levels of Strongyloides-specific IgG4 and IgG antibodies. By all diagnostic methods, male participants had a significantly higher prevalence of strongyloidiasis than females. Age was significantly associated with the concentration of specific serum IgG but not with the SsRapid grading score. In conclusion, SsRapid was shown to be a sensitive and valuable diagnostic test for the epidemiology study of strongyloidiasis.

Frequency of Rotavirus and Adenovirus in Children with Diarrhea

ABSTRACT Aim: The aim of this study is retrospective evaluation of the frequency of rotavirus and adenovirus in stool, and their distribution according to gender, age and seasons in children with diarrhea admitted at outpatients or hospitalized in our hospital. Material and Methods: Stool samples of patients aged between 0-18 years received at the Medical Microbiology Laboratory between 2021–2022 were evaluated for rotavirus–adenovirus. Rotavirus and adenovirus antigens were determined qualitatively by immunochromatographic cassette test method. Chi-square test was used in the statistical analysis. Results: A total of 1148 stool samples of pediatric patients were received by our laboratory during these two years for rotavirus and adenovirus antigen test. Of 1148 patients, 8.6% were positive for rotavirus, 5.1% for adenovirus, and 0.6% for both rotavirus and adenovirus antigens. Rotavirus and adenovirus was positive in 7.2% and 5.6% of males, respectively, and 10.6% and 4.5% of females, and there were no statistically significant differences. Rotavirus was most frequently found in the age group 3-5 years (11.6%) and adenovirus was most frequently found in the age group 6-9 years (8.4%), with no significant difference. Rotavirus was most frequently detected in spring (12.9%) while adenovirus was found most frequently in winter (8.1%), without significant differences. Antigen positivity was 4.1% and 4.9% in outpatients for rotavirus and adenovirus, respectively, and 15.1% and 5.5% in hospitalized patients. Rotavirus positivity was significantly higher in hospitalized patients than outpatients, and adenovirus positivity did not show a significant difference. Conclusion: We found that rotavirus and adenovirus were significant agents causing diarrhea in children, especially those younger than 5 years old, and that its frequency increased in winter and spring, and as rotavirus is a cause of hospitalization, implementation of rotavirus vaccine into routine vaccination programs seem to be beneficial for patients.

A-368 Aspergillus Galactomannan Lateral Flow Assay with Digital Reader for the Diagnosis of Invasive Aspergillosis

Abstract Background The Novel Aspergillus Galactomannan Lateral Flow Assay(Quic GM) from Dynamiker Biotechnology (Tianjin) Co., Ltd is a fluorescent immunochromatographic cassette test using a monoclonal antibody against GM with Digital Reader (Figure 1), which was rapid and easy to operate compared with the traditional GM ELISA assay. Here we conducte a comparative study between the Dynamiker Quic GM and the Platelia GM (Bio-Rad, USA) to validate the performance of the novel assay for the diagnosis of Invasive Aspergillosis (IA). Methods A total of 573 serum samples and 97 BALF samples with proven IA (Serum n = 9, BALF n = 2), probable IA (Serum n = 174, BALF n = 25), possible IA (Serum n = 98, BALF n = 16) and patients not fulfilling 2019 EORTC/MSG guideline IA criteria (control, Serum n = 292, BALF n = 54) were included. All the samples were tested in parallel using the Quic GM and Platelia GM. Results The total coincidence rate of Quic GM compared with Platelia GM was 97.91% (Kappa value was 0.95 > 0.75), 97.94% (Kappa value was 0.95 > 0.75) and 97.91% (Kappa value was 0.95 > 0.75) in serum samples, BALF samples and serum+BALF samples, respectively (Table 1). The concentrations generated by Quic GM and Platelia GM were linearly correlated (Serum: slope = 0.97, r2 = 0.96, P < 0.0001; BALF: slope = 0.95, r2 = 0.94, P < 0.0001) (Figure 2). Conclusion In conclusion, the Dynamiker Quic GM yielded significant consistency with Bio-Rad Platelia GM ELISA, and showed good performances for IA diagnosis, with the benefit of a relatively short handling time (around 20 min).

The Diagnostic Utility of Fast Tests for Detecting C-Reactive Protein in Synovial Fluid in Periprosthetic Joint Infections.

Despite the fact that many synovial fluid biomarkers have found application in the routine diagnosis of periprosthetic joint infection (PJI), this process still remains a challenge for orthopaedic surgeons. To simplify this process, fast point-of-care (POC) tests can be used during ambulatory visits and in operating room conditions. However, before such tests can be routinely used in clinical practice, they require validation. The purpose of the present study was to evaluate the diagnostic accuracy of different fast POC tests for detecting C-reactive protein (CRP) in synovial fluid for the diagnosis of PJI. Synovial fluid samples were collected from 120 consecutive patients who underwent revision total joint arthroplasty (TJA). The patients were divided into 2 groups. The first group included 76 patients who underwent revision for reasons other than infection (the aseptic revision TJA [arTJA] group), and the second group included 44 patients who underwent revision because of periprosthetic joint infection (PJI). The diagnosis of infection was made according to the International Consensus Meeting (ICM) 2018 criteria. All patients were operatively treated at a single orthopaedic center from January 2022 to February 2023. Four fast CRP tests with different cutoff values (1 and 3 mg/L, ≥8 mg/L, ≥10 mg/L [cassette], ≥10 mg/L [strip]) were used off-label for synovial fluid testing. Tests were performed on the same synovial fluid samples, and the results of these tests were compared with those obtained with the laboratory method. The cassette test with a minimum cutoff value of ≥8 mg/L demonstrated the best accuracy for the diagnosis of chronic PJI, with a sensitivity and specificity of 90.9% and 90.8%, respectively. For the cassette test with a cutoff value of >3 mg/L, the sensitivity and specificity were 68.2% and 77.6%, respectively. For the tests with a minimum cutoff value of ≥10 mg/L, the sensitivity and specificity were 77.3% and 94.7%, respectively, for the cassette test and 77.3% and 96.1%, respectively, for the strip test. The laboratory method with the statistically calculated threshold (2.7 mg/L) revealed the highest AUC (area under the receiver operating characteristic curve) value (0.95), with 90.9% sensitivity and 94.7% specificity. The cassette POC test with the minimum cutoff value of ≥8 mg/L had very good accuracy for the diagnosis of chronic PJI. This test had comparable sensitivity and slightly lower specificity in comparison with the laboratory method with the calculated threshold of 2.7 mg/L. Diagnostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Dried urine spot method for detection of Schistosoma mansoni circulating cathodic antigen in resource-limited settings: a proof of concept study.

Among the challenges in schistosomiasis surveillance and mapping surveys is the lack of a sensitive diagnostic method especially in low transmission setting. Currently, the WHO recommends the use point-of-care circulating cathodic antigen (Schisto POC-CCA) tests for surveillance and mapping of intestinal schistosomiasis. However, Schisto POC-CCA test has its drawbacks, one of which is the timely availability of test kits. One approach to overcoming this challenge is to develop a low-cost sampling method that allows for the collection and transport of urine specimens even in resource-limited settings. To develop a simple and efficient method for the collection and detection of Schistosoma mansoni (S. mansoni) CCA using urine spotted onto filter paper. To develop a dried urine spot (DUS) method, various dried matrix extraction parameters were tested and optimized using predesigned steps. The parameters include the size of filter paper (determined by the number of punches), volume of solvents, and type of solvent. Moreover, we optimized the incubation conditions (time and temperature). Urine and stool specimens to conduct the experiments were collected from volunteer fishermen in Mwanza and this project staff. Data were entered into the Microsoft Excel spreadsheet and IBM Statistical Package for the Social Sciences, version 20 for analysis. The optimal results were obtained when the procedure was run under the following conditions: Five punches of filter paper containing DUS were dissolved in 150 µl of distilled water and incubated at room temperature for 24 hours in an Eppendorf tube. More than 93% of the assays performed under these conditions produced results that were either comparable to or significantly better than the standard method. This study demonstrates the feasibility of collecting urine specimen (DUS) using filter paper and detecting Schistosoma CCA from DUS specimen using the Schisto POC-CCA cassette test.

Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel.

Central nervous system (CNS) infections such as meningitis and encephalitis are life-threatening conditions that demand hospital care and prompt identification of the causative agent. Since 2015, there has been only one CE-IVD-marked rapid multiplexed diagnostic assay in cassette format for bacterial and viral detection from cerebrospinal fluid (CSF): the BioFire FilmArray meningitis/encephalitis (ME) panel. In the beginning of 2022, Qiagen introduced the QIAstat-Dx meningitis/encephalitis panel. It is a CE-IVD-marked multiplex PCR cassette test intended for the identification of suspected infectious meningitis, encephalitis, or meningoencephalitis caused by bacterial, viral, or fungal pathogens. In this study, we evaluated patient and quality control samples using the QIAstat-Dx meningitis/encephalitis panel and compared the results to those of the BioFire FilmArray meningitis/encephalitis panel and reference methods (current routine analysis methods in our laboratory, PCR, or cultivation). The combined positive percent agreement between the two panel assays was 100%, and the negative percent agreement was 94%. We further compared specifically herpes simplex virus 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV) dilution series using six commercial herpesvirus assays, including the two cassette tests. The results suggested that real-time PCR methods (with separate extraction) were the most sensitive methods. When comparing the cassette tests, the BioFire FilmArray meningitis/encephalitis panel produced more positive results than the QIAstat-Dx meningitis/encephalitis panel in the herpesvirus analyses. IMPORTANCE The diagnosis of infectious meningitis and encephalitis relies mostly on specific PCR and culturing methods, but commercial syndromic panel assays are bringing a change in diagnostics. With multiplexed analysis, the identification of the pathogen is potentially faster, and less sample material is needed. The novel QIAstat-Dx meningitis/encephalitis panel assay is intended for the rapid identification of pathogens from cerebrospinal fluid for suspected central nervous system (CNS) infection, which is a life-threatening condition and difficult to diagnose. We studied the performance of this panel assay using patient samples and dilution series of selected viruses. The evaluation data for this novel meningitis/encephalitis panel assay are useful for other clinical laboratories and organizations using or considering using this test.

Efficacy, safety, and palatability of arpraziquantel (L-praziquantel) orodispersible tablets in children aged 3 months to 6 years infected with Schistosoma in Côte d'Ivoire and Kenya: an open-label, partly randomised, phase 3 trial

WHO has underlined the need for a child-friendly treatment for schistosomiasis, a prevalent parasitic disease in low-income and middle-income countries. After successful phase 1 and 2 trials, we aimed to evaluate the efficacy, safety, palatability, and pharmacokinetics of arpraziquantel (L-praziquantel) orodispersible tablets for preschool-aged children. This open-label, partly randomised, phase 3 study was conducted at two hospitals in Côte d'Ivoire and Kenya. Children with a minimum bodyweight of 5 kg in those aged 3 months to 2 years and 8 kg in those aged 2-6 years were eligible. In cohort 1, participants aged 4-6 years infected with Schistosoma mansoni were randomly assigned (2:1) to receive a single dose of oral arpraziquantel 50 mg/kg (cohort 1a) or oral praziquantel 40 mg/kg (cohort 1b) using a computer-generated randomisation list. Cohorts 2 (aged 2-3 years) and 3 (aged 3 months to 2 years) infected with S mansoni, and the first 30 participants in cohort 4a (aged 3 months to 6 years) infected with Schistosoma haematobium, received a single dose of oral arpraziquantel 50 mg/kg. After follow-up assessments, arpraziquantel was increased to 60 mg/kg (cohort 4b). Laboratory personnel were masked to the treatment group, screening, and baseline values. S mansoni was detected using a point-of-care circulating cathodic antigen urine cassette test and confirmed using the Kato-Katz method. The primary efficacy endpoint was clinical cure rate at 17-21 days after treatment in cohorts 1a and 1b, measured in the modified intention-to-treat population and calculated using the Clopper-Pearson method. This study is registered with ClinicalTrials.gov, NCT03845140. Between Sept 2, 2019, and Aug 7, 2021, 2663 participants were prescreened and 326 were diagnosed with S mansoni or S haematobium. 288 were enrolled (n=100 in cohort 1a, n=50 in cohort 1b, n=30 in cohort 2, n=18 in cohort 3, n=30 in cohort 4a, and n=60 in cohort 4b), but eight participants received antimalarial drugs and were excluded from the efficacy analyses. The median age was 5·1 years (IQR 4·1-6·0) and 132 (47%) of 280 participants were female and 148 (53%) were male. Cure rates with arpraziquantel were similar to those with praziquantel (87·8% [95% CI 79·6-93·5] in cohort 1a vs 81·3% [67·4-91·1] in cohort 1b). No safety concerns were identified during the study. The most common drug-related treatment-emergent adverse events were abdominal pain (41 [14%] of 288 participants), diarrhoea (27 [9%]), vomiting (16 [6%]), and somnolence (21 [7%]). Arpraziquantel, a first-line orodispersible tablet, showed high efficacy and favourable safety in preschool-aged children with schistosomiasis. The Global Health Innovative Technology Fund, the European and Developing Countries Clinical Trials Partnership, and the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945).

Comparison of Sensitivity and Specificity of Commercial Amphetamine Tests

Drug addiction is a disease that is characterized by a compulsion, a desire to take different substances permanently or for a certain period of time. Numerous negative incidents, such as crimes, work accidents and traffic accidents, are related to using illegal substances. Therefore, urine drug cassette tests have become a screening tool. However, considering legal consequences of test result, the question arises of their performance and reliability. On this account, the main objective of this study was to evaluate the sensitivity and specificity of urine drug tests available on the commercial pharmaceutical market. Evaluated tests were immersed in synthetic urine diluent spiked with amphetamine at various concentrations also containing potentially interfering substances such as caffeine, paracetamol and acetylsalicylic acid, and after a certain period of time, it was observed whether the result was as expected. The reference method used in this study was high-performance liquid chromatography. The obtained results confirmed the declared cut-off as well as specificity of rapid diagnostic tests.

Rapid cassette test results in anti-SARS-CoV-2 antibody screening verification by electrochemiluminescence immunoassay method

Rapid cassette test results in anti-SARS-CoV-2 antibody screening verification by electrochemiluminescence immunoassay method

Prevalence Of Malaria Among Blood Donors in The National Center for Blood Transfusion and Research in Sana’a Yemen

Background: Malaria has been killing millions of people worldwide. World Health Organization estimates that there are 300 million to 500 million of people infected with malaria. Therefore, the aim of this study is to explore the prevalence of malaria parasites among the blood donors attending the National Center for Blood Transfusion and Research in Sana’a, Yemen over a period of 6 months. Methods: Data collected from the National Center for Blood Transfusion and Research records for the year of 2012 and 2020. Secondary data were taken from 12.000 donors from 2012 and 18,000 from 2020. The records contain the patient’s number, blood bag, type of examination: cassette and confirmatory tests such as ELISA and type of malaria test. Results: In 2020, there were 814 Malaria-infected blood donors (97.8%), whereas, in 2012, there were only18 Malariainfected blood donors (2.2%). The male donors more infected (99.2%) than female donors (0.8%). The number of donors with blood group O+ were the highest infected people (50.4%), while the least infected donors is AB- (0.1%). The number of infected people with Plasmodium falciparum (24%) is the highest compared with other types of malaria (4%). The most packed cell volume (PCV) ratio among donor was 49%, the lowest PCV ratio in donors is 95% and 60% respectively. Conclusion: The study showed that the war played a significant role in increasing the number of people suffering from malaria and that the situation is worsening due to lack of awareness, migration and weak economic conditions.

Diagnostic performance of a urine-based ELISA assay for the screening of human schistosomiasis japonica: A comparative study.

The current study developed and evaluated the performance of a urine-based enzyme-linked immunosorbent assay (ELISA) for the screening of Schistosoma japonicum infection in a human cohort (n = 412) recruited from endemic areas, Northern Samar, the Philippines. The diagnostic performance of the urine ELISA assay was further compared with the Kato-Katz (KK) technique, serum-based ELISA assays, point-of-care circulating cathodic antigen (POC-CCA) urine cassette test, and droplet digital (dd)PCR assays performed on feces, serum, urine, and saliva samples, which were designated as F_ddPCR, SR_ddPCR, U_ddPCR, and SL_ddPCR, respectively. When urine samples concentrated 16× were assessed, the SjSAP4 + Sj23-LHD-ELISA (U) showed sensitivity/specificity values of 47.2/93.8% for the detection of S. japonicum infection in KK-positive individuals (n = 108). The prevalence of S. japonicum infection in the total cohort determined by the urine ELISA assay was 48.8%, which was lower than that obtained with the F_ddPCR (74.5%, p < 0.001), SR_ddPCR (67.2%, p < 0.001), and SjSAP4 + Sj23-LHD-ELISA (S) (66.0%, p < 0.001), but higher than that determined by the Sj23-LHD-ELISA (S) (24.5%, p < 0.001), POC-CCA assay (12.4%, p < 0.001), and SL_ddPCR (25.5%, p < 0.001). Using the other diagnostic tests as a reference, the urine ELISA assay showed a sensitivity between 47.2 and 56.9%, a specificity between 50.7 and 55.2%, and an accuracy between 49.3 and 53.4%. The concentrated urine SjSAP4 + Sj23-LHD-ELISA developed in the current study was more sensitive than both the KK test and POC-CCA assay, and showed a comparable level of diagnostic accuracy to that of the U_ddPCR. However, its diagnostic performance was less robust than that of the F_ddPCR, SR_ddPCR, and SjSAP4 + Sj23-LHD-ELISA (S) assays. Although they are convenient and involve a highly acceptable non-invasive procedure for clinical sample collection, the insufficient sensitivity of the three urine-based assays (the urine ELISA assay, the U_ddPCR test, and the POC-CCA assay) will limit their value for the routine screening of schistosomiasis japonica in the post mass drug administration (MDA) era, where low-intensity infections are predominant in many endemic areas.

P459 The Aspergillus lateral flow assay for the diagnosis of chronic pulmonary aspergillosis

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PMObjectivesChronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders. Measurement of Aspergillus-specific IgG antibodies had a higher sensitivity than either IgM, IgA, or IgE and it should therefore be considered the most appropriate test for screening CPA. Aspergillus-specific IgG antibody levels have been successfully used to monitor the response of CPA to medical therapy. Recently, a novel rapid test for Aspergillus-specific IgG antibody from Dynamiker Biotechnology (Tianjin) Co., Ltd. was released as a screening test of CPA. It is a fluorescent immunochromatographic cassette test using a monoclonal antibody against Aspergillus-specific IgG antibody and Europium nanoparticles (Eu NP) (Fig. 1). It is a semi-quantitative test which was easy to operate, rapid with portable detection devices, and can be widely accepted by clinical and primary medical (Fig. 2). We collect clinical samples to verify the detection performance of the Dynamiker Quic™Aspergillus-specific IgG antibody (LFA) test.MethodsIn total, 102 patients were included and 42 patients were diagnosed with CPA. The pathogen was identified from sputum, BALF culture, lung resection surgery, bronchos copy biopsy, percutaneous lung biopsy and BALF GM assay.ResultsThe sensitivity, specificity, PLR, NLP and Kappa index of the IgG antibody test were 85.6%,94.4%,14.0%,0.23% and 0.72, respectively.ConclusionsThe current work indicates that the Dynamiker Quic™ Aspergillus specific IgG antibody (LFA) test shows a promising application in the diagnosis of CPA. The results are accurate and reliable, and it could be used as an aid for the early rapid screening test of CPA.

P460 The Aspergillus Lateral Flow Assay for the diagnosis of invasive Aspergillosis

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM ObjectivesInvasive Aspergillosis (IA) is a life-threatening opportunistic mycosis that occurs in some people with a compromised immune system. The detection of Aspergillus galactomannan (GM) rapidly gained widespread acceptance as part of the diagnostic workup of a patient suspected of IA. Recently, a Novel QuicGM™ Aspergillus Galactomannan Ag Lateral Flow Assay (LFA) from Dynamiker Biotechnology (Tianjin) Co., Ltd. was released as a screening test of IA. It is a fluorescent immunochromatographic cassette test which using a monoclonal antibody against GM and Europium nanoparticles (Eu NP) (Fig. 1). It is a semi-quantitative test which was easy to operate, rapid with portable detection devices, and can be widely accepted by clinical and primary medical (Fig. 2). We conducted a comparative study between the Dynamiker QuicGMTM Aspergillus Galactomannan Ag (LFA) and the Bio-Rad Platelia™.MethodsA total of 66 serum samples and 54 BALF samples were collected, 15 serum samples from the College of American Pathologists (CAP) certificated lab were also included in this study. The samples were tested in parallel using the Bio-Rad Platelia™ Aspergillus Ag (ELISA) and Dynamiker QuicGM™ Aspergillus Galactomannan Ag (LFA).ResultsThe total coincidence rate of the two assays was 98.48% (Kappa value was 0.97 >0.75) and 90.74% (Kappa value was 0.81 >0.75) in 66 serum samples and 54 BALF samples respectively.ConclusionsThe performance of the Dynamiker QuicGM™Aspergillus Galactomannan Ag (LFA) and Bio-Rad Platelia™ Aspergillus Ag (ELISA) were highly consistent, and the performance of Dynamiker Aspergillus Galactomannan kit were all in line with the statement of the manufacturer. The results are accurate and reliable, and it could be used as an aid for the early rapid screening test of IA.

Rotavirus and adenovirus prevalence in patients with acute viral gastroenteritis in Denizli, Turkey, 2017-2021.

This study aims to determine retrospectively the prevalence of rotavirus and enteric adenovirus in patients with gastroenteritis symptoms and the distribution of pathogens by gender, age, seasons, and years. The stool samples sent to Pamukkale University Healthcare Research and Practice Hospital's Medical Microbiology laboratory between January 2017 and December 2021 were evaluated for rotavirus/adenovirus antigen positivity. Rotavirus and adenovirus antigens were studied with the Rotavirus-Adenovirus Combo Rapid Cassette Test (Acro Biotech) kit. Rotavirus was detected in 683 (8.2%) of the 8315 stool samples evaluated, and 180 (2.2%) samples were positive for adenovirus. Coinfection was detected in 21 (0.25%) samples. Rotavirus was found at the highest rate in 2019 (p = 0.001). The adenovirus was detected in 2020 at a lower rate than in other years (p = 0.0001). The rotavirus was observed at a higher rate in 0-<3, 3-<6, and 6-<13 age groupsand adenovirus was detected at a higher rate in 3-<6 and 6-<13 age groups compared to other age groups (p = 0.001, p = 0.003, respectively). The highest rate of incidence of the rotavirus was found in spring and adenovirus in winter. In the etiology of gastroenteritis, especially in children, adenovirus and rotavirus should not be ignored in winter and spring. The prevalence of rotavirus was observed to have decreased in 2020 and onwards, and the prevalence of adenovirus decreased in 2020.

Urinalysis based assessment of compliance and drug use patterns in patients prescribed tramadol: A cross-sectional study from a tertiary care centre.

Strict adherence to pharmacological dosage regimens is a prerequisite to the success of most treatments, particularly for patients in drug abuse programs. The compliance of tramadol, an atypical non-scheduled narcotic analgesic, using objective method has not been adequately studied in an Indian setting. To evaluate the compliance and pattern of drug use among opioid-dependent subjects prescribed tramadol based on urinalysis. Fifty male opioid-dependent patients (ICD 10), seeking treatment at a tertiary de-addiction treatment centre of North India on tramadol prescription for atleastpast four weeks were included. Self-reported substance use was recorded using semi-structured proforma. Ten ml of urine was collected for the assessment of compliance of tramadol of other substance use (morphine, buprenorphine, dextropropoxyphene, pentazocine, cannabis, benzodiazepines, pheniramine). All these drugs were analyzed using the immunoassay-based Cassette test and Gas Chromatography in human urine. Mean age of the participants was 42.8 years and the mean duration of opioid use was 15.9years. The urine specimen of all subjects tested positive for tramadol. Urinalysis revealed benzodiazepines, cannabis, and pheniramine to be the most common substances of use in this population. It was seen that agreement of self-reporting and urine test results was good for morphine (κ=0.558) and cannabis (κ=0.312) and was poor for buprenorphine, pentazocine, and pheniramine. The study demonstrates the continued use of several illicit or non-prescribed medications in a medication-assisted opioid treatment population. The results affirm the reliability of urinalysis as an adjunct for testing compliance in such a population.

Ash from Poultry Manure Incineration as a Substitute for Phosphorus Fertiliser

The goal of the tests was to separate a phosphate concentrate from ash and to assess its fertiliser use efficiency in anthropogenic land. Ash obtained from poultry manure incineration is an interesting fertiliser, as it contains both of the necessary nutrients, i.e., phosphorus and potassium. The ash selected for the tests contained 15.73 wt% P2O5, and 6.75 wt% K2O. CaO also constituted the main component (44.79 wt%). Phosphorus in crystalline form was present as hydroxyapatite and carbonate apatite. The first stage, applied in order to separate a phosphate concentrate from ash, involved a number of physicochemical methods: (i) a method based on grain wettability differences; (ii) a method based on grain density differences; and (iii) methods based on size distribution differences. Wet sieving made it possible to separate a fraction with a P2O5 content of 24.56 wt%. The second stage, applied to assess fertiliser use efficiency, involved cassette tests as well as pot and field cultivation using as fertiliser, the obtained product as well as raw ash and commercial ones. Therefore, the conducted research allowed for the development of a methodology for the management of ash from the incineration of a poultry manure and their use as a substitute for phosphorus fertiliser. The tested material was applied in various doses. Using the obtained phosphate concentrate at a dose of 95 g/m3 resulted in a comparable yield as in the case of the commercial fertiliser at a dose recommended by the producer (75 g/m3). Unprocessed ash had to be used in larger amounts, i.e., 165 g/m3, to have a comparable yield as a commercial fertiliser.

SEROPREVALENCE OF ANTI-TOXOPLASMA GONDII ANTIBODIES IN THE MOST CONSUMED LIVESTOCK AND POULTRY IN GAZA – PALESTINE

It is commonly established that warm blooded animals are extremely vulnerable to the infectious coccidian parasite, Toxoplasma gondii. T. gondii can be transmitted to poultry and livestock through the ingestion of oocyst (fecal-oral), and placenta (congenital toxoplasmosis) in livestock. Cattle, sheep, and rabbits are some of the most consumed livestock in Palestine. As for poultry, backyard chicken, caged chicken, and caged turkeys are some of the most consumed birds. The aim of the present study is to detect the seroprevalence of Anti-T. gondii antibodies (IgG/IgM) among the frequently consumed livestock and poultry, which is collected from farms and slaughterhouses in Gaza, Palestine. For this specific study, blood samples from 213 cattle, 100 sheep, and 99 rabbits were collected. On the other hand, 50 blood samples from each type of poultry mentioned above were also collected. The criteria of samples collection based on a quick survey was performed among animal breeders and slaughterhouses owners in the study area, under the guidance of the colleagues in the Palestinian Ministry of Agriculture (veterinary department), as well as with the support of documented references as the targeted animal groups are the most suitable for meat production regardless of age and gender. The collected samples were analyzed through the use of the ELISA technique and Rapid Cassette Test. The results of the present study showed a high seroprevalence of Anti-T. gondii antibodies among sheep, which was 64.00 % and 13.14% among cattle. On the other hand, the results among backyard chicken and caged chicken were 26.00% and 2.00%, respectively. However, no antibodies were detected in the serum of rabbits and caged turkeys.

Prevalence of Helicobacter pylori infection and its association with blood groups in patients presenting epi-gastric pain in Umaru Shehu ultra-modern hospital, Maiduguri, Nigeria

Helicobacter pylori is a gram-negative bacterium that causes peptic ulcer and is also involved in gastric mucosa-associated lymphoid tissue lymphomas. The objective of the present study was to determine seroprevalence of Helicobacter pylori among patients complaining of epigastric pain at Umaru Shehu ultra-modern hospital Maiduguri, Nigeria. A rapid diagnostic cassette test kit for the qualitative detection of Helicobacter pylori was used in this study. A random sampling technique was used to collect blood samples and obtain other demographic variables that include sex, age and blood group which are considered as risk factors for contracting Helicobacter pylori. Out of the 50 patients tested, 45 (90.0%) were positive. The positive patients comprised 10 out of 12 males (83.3%) and 35 out of 38 females (92.1%). Patients within the age groups 10-20, 31-40 and &gt;50 years had a prevalence of 100% each, while patients between 21-30 years and those 41-50 years had a prevalence of 88.9% and 62.5% respectively. When their blood groups were considered, the AB group had a prevalence of 100% followed by the A group (95%) while the O and B groups had 90.5% and 75%, respectively. Patients complaining of epigastric pain should be screened for Helicobacter pylori, particularly in early cases and among people living in clusters or under inadequate sanitary conditions, such as internally displaced persons.

A point-of-care cassette test for detection of Strongyloides stercoralis

Strongyloides stercoralis is a parasite that causes strongyloidiasis worldwide. It may lead to a life-long infection in immunocompetent people and hyperinfection in immunosuppressed patients. A point-of-care (POC) rapid test is helpful for patient diagnosis in resource-limited settings and as a detection tool in elimination/control programs. Previously, we reported a rapid IgG4 dipstick test (Ss Rapid®) for Strongyloides suitable for a laboratory setting. A POC cassette format of the test, which is field-applicable, has since been developed. Here, we report on a laboratory-based evaluation of the Ss Rapid® cas sette test on 285 sera. We assessed the diagnostic sensitivity of the Ss Rapid® cas sette with 32 sera, comprising samples from larval and/or DNA positive individuals from three countries. Additionally, we also tested samples from 33 seropositive endemic areas residents. We evaluated the diagnostic specificity of the test using 220 samples, comprising sera from other infections (n = 101), allergy cases with high IgE antibodies (n = 4), and blood donors (n = 115). The test showed high diagnostic sensitivity (97%, 31/32), and all sera of the seropositive endemic residents were reactive. It also showed high diagnostic specificity (94.5%, 208/220), and all false-positive samples tested negative after sera adsorption using recombinant NIE-coated microsphere beads. Additionally, we showed that the test worked with spiked whole blood samples. The study results showed that the SsRapid® cas sette test merits further laboratory and field evaluations.

Performance of the point-of-care circulating cathodic antigen test in the diagnosis of schistosomiasis japonica in a human cohort from Northern Samar, the Philippines

BackgroundZoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines.MethodsClinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference.ResultsThe POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1–9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort.ConclusionsBy using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity.Graphic abstract