Immunochromatographic Card Test Research Articles

Filariasis-Associated Secondary Membranous Nephropathy: A Rare Presentation

Parasitic infections like filariasis are uncommon causes of secondary membranous nephropathy (MN) which requires serological tests to detect circulating Wuchereria bancrofti antigens for its diagnosis or the identification of microfilariae in the capillary lumen on kidney biopsy. The immunochromatographic card tests is simple, non invasive and has high sensitivity and specificity. We report a case of 30 year old lady who presented to us with nephrotic syndrome which on kidney biopsy showed features of membranous nephropathy with negative staining for Anti PLA2R, THSD7A and exostosin. A thorough workup was done to find out any secondary cause of MN where she was found positive with filiarial antibody test. Hence, a diagnosis of secondary membranous pattern nephropathy was considered for which she was treated with diethylcarbamazine (DEC) and other supportive medications which on follow up showed marked resolution of proteinuria.

Molecular Characterization of Giardia intestinalis and Cryptosporidium spp. Detected in Humans in Ağrı, Türkiye.

We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Ağrı, Türkiye. This study included 184 patients who applied to Ağrı-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of β-giardin gene were used genotype G. intestinalis. Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId sub-type family. The G. intestinalis were identified assemblages A. Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Ağrı, Türkiye.

Postintervention Immunological and Entomological Survey of Lymphatic Filariasis in the City of Olinda, Brazil, 2015-2016.

Lymphatic filariasis (LF) is a leading cause of disability due to infectious disease worldwide. The Recife Metropolitan Region (RMR) is the only remaining focus of LF in Brazil, where the parasite Wuchereria bancrofti is transmitted solely by the mosquito Culex quinquefasciatus. This study reports the results of transmission assessment surveys and molecular xenomonitoring in the city of Olinda, RMR, after nearly 15 years (2015-2016) of interventions for LF elimination. Participants were screened for W. bancrofti antigen via immunochromatographic card tests (ICT) in: 1) door-to-door surveys conducted for all children aged 5-7 years from 4 out of 17 intervention areas treated with at least five annual doses of mass drug administration (MDA), and 2) a two-stage cluster sampling survey of residents aged 5 years and older in non-MDA areas. Mosquitoes were collected via handheld aspirators in four MDA areas, differentiated by species, sex, and physiological status, pooled into groups of up to 10 blood-fed, semigravid, and gravid mosquitoes, and screened for W. bancrofti infection by real-time quantitative polymerase chain reaction (RT-qPCR). All 1,170 children from MDA areas and the entire population sample of 990 residents in non-MDA areas were ICT negative. In MDA areas, a total of 3,152 female Cx. quinquefasciatus mosquitoes in 277 households (range, 0-296 mosquitoes per house) were collected via aspiration. RT-qPCR of 233 pools of mosquitos were negative for W. bancrofti RNA; an independent reference laboratory confirmed these results. These results provide evidence that LF transmission has been halted in this setting.

EVALUATION OF LYMPHATIC FILARIASIS AFTER TWO ROUNDS OF MASS DRUG ADMINISTRATION IN LAU LOCAL GOVERNMENT AREA OF TARABA STATE NIGERIA

This study was undertaken to evaluate the effects of Mass Drug Administration (MDA) on Wuchereria bancrofti (microfilariae) after two rounds of combined Ivermectin and Albendazole distribution. A total of 221 participants were recruited in three communities in Lau Local Government Area of Taraba State by convenience sampling method. Questionnaires and physical examinations were used to assess clinical manifestations associated with the infection. Blood samples were collected by finger prick method and stained with Giemsa stain for examination to establish the presence of W. bancrofti while immunochromatographic card test was performed to determine the presence of filarial antigen in serum. Previous data were used to determine the pre-drug prevalence of the parasite. The results showed that the drug did not significantly reduce the clinical manifestations reported among the patients. The microfilariae prevalence and microfilaria mean density after two rounds of drug administration was 19.5% and 1.49%, while the pre- MDA prevalence and microfilaria mean density was 27.8% and 2.44% respectively. There was a statistically significant decrease of microfilaria prevalence (P<0.05) after two rounds of MDA. There was no significant effect of MDA by age, sex and occupation-related microfilariae prevalence in the study area. In conclusion, the study reveals that microfilaria prevalence and load decreased after two rounds of MDA of combined Ivermectin and Albendazole distribution amongst the studied populations. Routine evaluation of the MDA is required to assess the impact of the drug for the eventual elimination of the infection.

Field Comparison between Blood Immunochromatographic Card Test and Microscopy in Diagnosis of Bancroftian Filariasis in Northern Taraba State, Nigeria

Field Comparison between Blood Immunochromatographic Card Test and Microscopy in Diagnosis of Bancroftian Filariasis in Northern Taraba State, Nigeria

OCCURRENCE OF HEPATITIS B AND HEPATITIS C AND THEIR DUAL INFECTIONS: A GREAT PUBLIC HEALTH CONCERN

Introduction-Viral hepatitis is one of the major public health concern worldwide. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are of great concern due to their association with cirrhosis and hepatocellular carcinoma. Aims & Objectives-i)To determine the frequency of Hepatitis B surface antigen and anti-HCV antibodies in patients coming to a tertiary care teaching hospital ii)To estimate the occurrence of co-infection with hepatitis B virus and hepatitis C virus iii) To analyse the risk factors associated with hepatitis B, hepatitis C and their co-infections. Method- This prospective study included serum samples which were subjected to detection of HBs antigen and anti-HCV antibodies using rapid immunochromatographic card tests, which were further confirmed by Enzyme Linked Immunosorbent Assay (ELISA). Results- Out of total of 12,502 cases, the seropositivity of HBs antigen and anti-HCV antibodies was found to be 3.6% (452 /12,502) and 6.1% (758 /12,502) respectively. The frequency of co-infection (HBs antigen and anti-HCV antibodies) was found to be 0.8% (99 /12,502). Male to female ratio for hepatitis B, hepatitis C and co-infection was 2.1:1, 1.6:1and 2.3:1, respectively. The commonest risk factor associated with seropositivity of HBV was intravenous drug use, followed by blood / blood components transfusion. Hepatitis C infection was most commonly seen with blood / blood components transfusion, followed by intravenous drug use. Conclusions: Counseling and health education regarding the safe injection practices, safe sexual practices , screening of blood / blood products and vaccination against HBV are the essential steps to combat viral hepatitis.

Epidemiological and parasitological studies on lymphatic filariasis in Argungu Local Government Area of Kebbi State, Nigeria

Mass Medicine Administration (MMA) with albendazole and ivermectin has been going on in Argungu Local Government Area of Kebbi State for over six years. Apart from the baseline mapping conducted by the state ministry of health in 2010 to identify communities eligible for MDA, no comprehensive study has been carried out on this disease in the area. This study is necessary to determine if transmission has been halted or not. A total of 425 volunteers in 6 rural villages were examined using Immunochromatographic Card Test (ICT) and routine microscopy . Physical manifestations and entomological studies were also carried out. Nine inhabitants, 9(0.4%) were positive using ICT with no microfilaria of W. bancrofti. Infection was significantly higher in Matan Fada Village (7.14%) (p<-0.5), while three villages recorded 0.00% infection rate. Infection was higher in males than females, age group 10-19, in singles than married participants, pupils/students than other occupations (p>0.5). There was weak negative correlation between ICT and hydrocele(r = -0.14) as well as lymphoedema (r = -0.012). 436 mosquitoes were dissected and none harboured microfilaria of W. bancrofti. It is concluded that transmission has been halted in 3 of the villages since they have met the WHO’s criteria of less than 1% seropositivity, and MMA should therefore be stopped in those villages. There is however continued surveillance, morbidity management and vector control.
 Keywords: Entamological studies; microfilaria; mobidity management.

Comparison of Methods for Detection of Chlamydia trachomatis in Cervical from Women in Mosul City

The study included detection of Chlamydia trachomatis in the cervix of symptomatic and a symptomatic woman. A total of (60) woman aged between (16-<45) years were diagnosed by the consultant of the general hospital in Mosul city during the period May until the end of December 2013. Three endocervical swabs were collected from each woman. One of the three swabs was stained with Giemsa stain for direct examination by light microscope, and the other swabs was put in 0.2M sucrose phosphates transport media then inoculated in yolk Sac of embryonated chicken eggs, and the last endocervical swabs was used for detection of chlamydia by using rapid immunochromatographic card test . From each woman participated in this study 5 ml of venous blood was collected to detect the immunoglobulin (IgG) by ELISA and indirect microimmuno flourescence test. The result showed that C.trachomatis was presented in percentage (35%) by Indirect microimmunoflourescence test (30%) by ELISA (25%) by culturing (21.6) by Giemsa stain, , (5%) by rapid test in symptomatic and asymptomatic women. This result showd that Indirect MicroimmunoaFlourecence is more specific to detect Chlamydia than other test while the rapid test was of no value in detection of chlamydia in endocervical swabs Also the result showed that the percentage of Chlamydia in a asymptomatic woman such as infertility and abortion had high percentage than symptomatic woman such as vaginal discharge, abdominal pain' and ectopic pregnancy . Also the result showed that the isolation rate in age group (21-30) years was the more dominate than other age group.

Molecular xenomonitoring as a post-MDA surveillance tool for global programme to eliminate lymphatic filariasis: Field validation in an evaluation unit in India.

BackgroundLymphatic filariasis (LF) is targeted for elimination by the year 2020. As of 2017, 67 of the 72 endemic countries have implemented annual Mass Drug Administration (MDA) for interrupting LF transmission. Transmission Assessment Survey (TAS) is the recommended protocol to evaluate the impact of MDA and to decide when to stop MDA in an Evaluation Unit (EU, population ≤2 million). As the human infection levels go down with repeated MDA rounds, it becomes a challenge to select the appropriate survey methods to assess transmission interruption. This study validates a standard protocol for molecular xenomonitoring of infection in vectors (MX) at an EU as a complementary tool for TAS to stop MDA and its utility for post-MDA or post-validation surveillance.MethodologyThe study was conducted in Cuddalore district, Tamil Nadu, India, which was found eligible for TAS after 15 annual rounds of MDA (4 with DEC alone and 11 with DEC plus albendazole). The district was divided into two EUs as per the TAS protocol and one EU was randomly selected for the study. A two-stage cluster design vector sampling, developed and validated at a sub-district level, was implemented in 30 randomly selected clusters in the EU. Female Culex quinquefasciatus were collected placing gravid traps overnight (1800–0600 hrs) inside the premises of systematically selected households. Pools of 20–25 blood-fed, semi-gravid and gravid Cx. quinquefasciatus were subjected to real-time quantitative PCR (polymerase chain reaction) assay for detecting Wuchereria bancrofti DNA. Pool infection rate (% of pools positive for W. bancrofti DNA), and the estimated prevalence of W. bancrofti DNA in mosquitoes and its 95% confidence interval were calculated. Additionally, in these 30 clusters, microfilaria (Mf) survey among individuals >5 years old was carried out. School-based TAS was conducted using Immunochromatographic Card Test (ICT) in the EU. Prepared itemized cost-menu for different cost components of MX survey and TAS were estimated and compared.ResultsMX survey showed that only 11 (3.1%) of the 358 pools (8850 Cx.quinquefasciatus females), collected from 30 clusters, were found positive for W. bancrofti DNA. The estimated vector infection rate was 0.13% (95% CI: 0.07–0.22%), below the provisional threshold (0.25%) for transmission interruption. Of 1578 children tested in the TAS, only four (0.25%) were positive for filarial antigenemia, and it is well below the critical cut-off (18 positives) for stopping MDA. Among 9804 persons tested in the 30 clusters, only four were found positive for Mf (0.04%; 95% CI: 0.01–0.1%). The Mf-prevalence was <1% threshold for transmission interruption in humans. The estimated costs for TAS and MX per EU were $14,104 USD and $14,259 USD respectively.ConclusionsThe result of MX protocol was in good agreement with that of TAS, providing evidence to recommend MX as a complementary tool to TAS to decide on stopping MDA. MX can also be a potential surveillance tool for post-MDA and post-validation phases as it could detect sites with residual infection and risk of resurgence of transmission. MX is economically feasible as its cost is slightly higher than that of TAS.

A case series of atypical manifestations of dengue

Dengue fever is an arthropod-borne viral illness caused by Flavivirus and transmitted by Aedes aegypti mosquito. With rising burden of disease, atypical manifestations have increased. In our case series, we report five cases of serologically proven dengue-positive patients (by immunochromatographic dengue card test) with atypical manifestations. The first two patients presented with dengue encephalitis and the next two patients presented with viral pneumonia. The second, fourth, and fifth cases were dengue in cirrhotic patients leading to decompensated liver disease. The fourth case succumbed to death due to refractory shock. We should have a high index of suspicion and knowledge to detect atypical manifestations of dengue fever as they are more fatal and are increasing in incidence. In preexisting liver disease, chances of bleeding are high even though platelet counts are not very low. Only appropriate timely intervention can prevent morbidity and mortality.

Assessment of transmission in areas of uncertain endemicity for lymphatic filariasis in Brazil.

BackgroundThe objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil.Methodology/Principle findingsFor review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6–10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child’s family came from Recife, but no other case was diagnosed within the family.Conclusions/SignificanceThe study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.

Mapping the baseline prevalence of lymphatic filariasis across Nigeria

IntroductionThe baseline endemicity profile of lymphatic filariasis (LF) is a key benchmark for planning control programmes, monitoring their impact on transmission and assessing the feasibility of achieving elimination. Presented in this work is the modelled serological and parasitological prevalence of LF prior to the scale-up of mass drug administration (MDA) in Nigeria using a machine learning based approach.MethodsLF prevalence data generated by the Nigeria Lymphatic Filariasis Control Programme during country-wide mapping surveys conducted between 2000 and 2013 were used to build the models. The dataset comprised of 1103 community-level surveys based on the detection of filarial antigenemia using rapid immunochromatographic card tests (ICT) and 184 prevalence surveys testing for the presence of microfilaria (Mf) in blood. Using a suite of climate and environmental continuous gridded variables and compiled site-level prevalence data, a quantile regression forest (QRF) model was fitted for both antigenemia and microfilaraemia LF prevalence. Model predictions were projected across a continuous 5 × 5 km gridded map of Nigeria. The number of individuals potentially infected by LF prior to MDA interventions was subsequently estimated.ResultsMaps presented predict a heterogeneous distribution of LF antigenemia and microfilaraemia in Nigeria. The North-Central, North-West, and South-East regions displayed the highest predicted LF seroprevalence, whereas predicted Mf prevalence was highest in the southern regions. Overall, 8.7 million and 3.3 million infections were predicted for ICT and Mf, respectively.ConclusionsQRF is a machine learning-based algorithm capable of handling high-dimensional data and fitting complex relationships between response and predictor variables. Our models provide a benchmark through which the progress of ongoing LF control efforts can be monitored.

The Habit Of Using Blankets Or Sleepwear Uncompletely At Night As A Risk Factor For Filariasis In Primary School-Aged Children

Filariasis is caused by 3 species of filarial worms and is transmitted by the Culex quinquefasciatus mosquito. Pekalongan Regency is an endemic filariasis area with an Mf rate of &gt;1%. The prevalence of filariasis in primary school children is 1.98% in Tirto and Buaran Subdistricts, the behavior of using blankets / complete clothing while sleeping at night in children needs to be studied further to prove the risk factors for filariasis. This study is a cross sectional analytic study, to prove the use of blankets / complete clothing during night sleep as a risk factor for the incidence of filariasis, using purposive samples of 84 samples of primary school age children in grades 3, 4, 5, 6. The stage of this research is finger blood screening using Immunochromatographic Card Test (ICT), indept interview and direct observation in Tirto and Buaran Subdistricts of Pekalongan Regency. The results of screening 17 positive and 67 negative filariasis were obtained. The results of the analysis using Chi Square did not use blankets / complete clothing while sleeping at night, p = 0,000 and POR = 10,967 (95% CI: 2,837-42,400). Not using mosquito nets when sleeping at night p value = 0.022 and POR = 4.527 (95% CI: 1.335-15.3353). The habit of playing in the open space / place of breeding / resting vector is obtained p = 0.830 and POR = 1.383 (95% CI: 0.401-4.764). Not using blankets / complete clothes while sleeping at night and not using mosquito nets while sleeping at night is a possible risk factor for filariasis in primary school-aged children.

Serological evidence of human leptospirosis in patients with acute undifferentiated febrile illness from Uttarakhand, India: A pilot study.

CONTEXT:To the best of our knowledge, there are no reports of serological evidence of human leptospirosis from Uttarakhand state in India.AIMS:The aim of this study was to screen for serological evidence of leptospirosis in patients with acute undifferentiated febrile illness at a tertiary care teaching hospital in Uttarakhand.SETTINGS AND DESIGN:A pilot study was conducted from March to November 2017.SUBJECTS AND METHODS:Fifty-three adult patients who presented in Medicine outpatient Department with a history of fever of ≥7 up to 14 days duration with or without other associated symptoms such as a headache, rashes, myalgia, arthralgia, and conjunctival suffusion were enrolled in the study using convenience sampling technique. Blood samples of these patients were collected and subjected to peripheral smear examination for malaria parasites, dengue immunoglobulin M (IgM) immunochromatographic card test, IgM Typhidot, Leptospira and Scrub typhus IgM ELISA, respectively. Aerobic blood culture was performed in 24 cases. Relevant clinico-epidemiological details were obtained as per the pro forma formulated in accordance with the modified Faine's criteria.STATISTICAL ANALYSIS USED:Descriptive statistics.RESULTS:The study population consisted of 50.94% of males and 49.06% of females with a mean age ± standard deviation of 34.2 ± 15.2 years. Fifty febrile patients had additional symptoms of which myalgia was the most common (81.1%) followed by arthralgia (22.6%). Peripheral smears of all patients were negative for malaria parasites. Dengue and Typhidot IgM positivity was observed in two and eight patients, respectively. Six and five patients were tested positive by leptospira and scrub typhus IgM ELISA, respectively. Salmonella Typhi was isolated from blood sample of only one patient. Serum samples of two patients showed dual positivity. All six leptospira seropositive patients satisfied modified Faine's criteria.CONCLUSIONS:Leptospirosis is a seemingly unexplored infection in Uttarakhand and should be considered as a differential diagnosis in patients with acute undifferentiated febrile illness.

Rapid Epidemiological Assessment of Lymphatic Filariasis in Northern Taraba Focus, Nigeria

This study was undertaken to determine the prevalence of Lymphatic Filariasis in eleven (11) foci communities of northern Taraba state. Blood samples were collected by finger prick method to determine the presence of filarial antigen in serum using immunochromatographic card test. Questionnaires and physical examinations were used to assess clinical manifestations associated with the infection. The result showed that 101/336 (30.02%) were positive for W. bancrofti circulating filarial antigen. The circulating filarial antigen prevalence among the eleven communities differ significantly (p 0.05). However, the antigenaemia prevalence among the age groups differs, with ages 51-60 years having the highest prevalence among male and ages 41-50 years among female respectively (χ2=11.424, df 6, P<0.05). Chronic clinical manifestation observed include Hydrocoel (17.12%) and lymphoedema of limbs (20.08%). Female had significant proportion of those with lymphoedema (14.8%). The findings showed a high prevalence of the infection which is far above the World Health Organisation threshold level of ≥1% prevalence as well as significant prevalence of clinical manifestations. Therefore integrated intervention programme is required in the study area.

Prevalence and risk factors associated with lymphatic filariasis in American Samoa after mass drug administration

BackgroundIn 2000, American Samoa had 16.5% prevalence of lymphatic filariasis (LF) antigenemia. Annual mass drug administration (MDA) was conducted using single-dose albendazole plus diethylcarbamazine from 2000 to 2006. This study presents the results of a 2007 population-based PacELF C-survey in all ages and compares the adult filarial antigenemia results of this survey to those of a subsequent 2010 survey in adults with the aim of improving understanding of LF transmission after MDA.ResultsThe 2007 C-survey used simple random sampling of households from a geolocated list. In 2007, the overall LF antigen prevalence by immunochromatographic card test (ICT) for all ages was 2.29% (95% CI 1.66–3.07). Microfilaremia prevalence was 0.27% (95% CI 0.09–0.62). Increasing age (OR 1.04 per year, 95% CI 1.02–1.05) was significantly associated with ICT positivity on multivariate analysis, while having ever taking MDA was protective (OR 0.39, 95% CI 0.16–0.96). The 2010 survey used a similar spatial sampling design.The overall adult filarial antigenemia prevalence remained relatively stable between the surveys at 3.32% (95% CI 2.44–4.51) by ICT in 2007 and 3.23 (95% CI 2.21–4.69) by Og4C3 antigen in 2010. However, there were changes in village-level prevalence. Eight village/village groupings had antigen-positive individuals identified in 2007 but not in 2010, while three villages/village groupings that had no antigen-positive individuals identified in 2007 had positive individuals identified in 2010.ConclusionsAfter 7 years of MDA, with four rounds achieving effective coverage, a representative household survey in 2007 showed a decline in prevalence from 16.5 to 2.3% in all ages. However, lack of further decline in adult prevalence by 2010 and fluctuation at the village level showed that overall antigenemia prevalence at a broader scale may not provide an accurate reflection of ongoing transmission at the village level.

Risk Factors for Podoconiosis: Kamwenge District, Western Uganda, September 2015.

AbstractPodoconiosis, a noninfectious elephantiasis, is a disabling neglected tropical disease. In August 2015, an elephantiasis case-cluster was reported in Kamwenge District, western Uganda. We investigated to identify the disease's nature and risk factors. We defined a suspected podoconiosis case as onset in a Kamwenge resident of bilateral asymmetrical lower limb swelling lasting ≥ 1 month, plus ≥ 1 of the following associated symptoms: skin itching, burning sensation, plantar edema, lymph ooze, prominent skin markings, rigid toes, or mossy papillomata. A probable case was a suspected case with negative microfilaria antigen immunochromatographic card test (ruling out filarial elephantiasis). We conducted active case-finding. In a case-control investigation, we tested the hypothesis that the disease was caused by prolonged foot skin exposure to irritant soils, using 40 probable case-persons and 80 asymptomatic village control-persons, individually matched by age and sex. We collected soil samples to characterize irritants. We identified 52 suspected (including 40 probable) cases with onset from 1980 to 2015. Prevalence rates increased with age; annual incidence (by reported onset of disease) was stable over time at 2.9/100,000. We found that 93% (37/40) of cases and 68% (54/80) of controls never wore shoes at work (Mantel-Haenszel odds ratio [ORMH] = 7.7; 95% [confidence interval] CI = 2.0-30); 80% (32/40) of cases and 49% (39/80) of controls never wore shoes at home (ORMH = 5.2; 95% CI = 1.8-15); and 70% (27/39) of cases and 44% (35/79) of controls washed feet at day end (versus immediately after work) (OR = 11; 95% CI = 2.1-56). Soil samples were characterized as rich black-red volcanic clays. In conclusion, this reported elephantiasis is podoconiosis associated with prolonged foot exposure to volcanic soil. We recommended foot hygiene and universal use of protective shoes.

Clinico-epidemiological profile of dengue cases in a Medical College Hospital, Bengaluru, Karnataka, India

Background: Medical college hospital being a tertiary care center receives a significant number of dengue cases from within and outside the catchment area and provides a good opportunity to study the clinical and epidemiological features of dengue infection, its prognosis and outcome so as to institute prompt preventive and control measures. The objective was to describe the clinico-epidemiological features of dengue cases admitted to pediatric ward at a Medical College Hospital, Bengaluru, Karnataka, India.Methods: Cross-sectional study of 140 cases positive for NS1Ag, IgM and/or IgG by dengue rapid immuno-chromatographic card test, admitted in pediatric ward during June to August 2013 at Rajarajeswari Medical College and Hospital.Results: Majority of the patients were from rural area. Fever was present in all 140 cases. Vomiting followed by headache were the common presenting symptoms. Of the 140, 50% cases were classified as dengue fever without warning signs, 46.4% as dengue fever with warning signs and 3.6% as severe dengue. Thrombocytopenia was present in 77.1%, leucopenia in 47.9%, and raised haematocrit in 52.1% of cases. Mortality rate was 0.71%.Conclusions: Children above 5 years of age were most commonly affected age group. About 5 (3.6%) of the patients belonged to severe dengue category according to revised WHO Dengue Case Classification.

Molecular xenomonitoring (MX) and transmission assessment survey (TAS) of lymphatic filariasis elimination in two villages, Menoufyia Governorate, Egypt.

Lymphatic filariasis (LF) is focally endemic in Egypt where the female mosquito, Culex pipiens, is responsible for its transmission. The aim of the study was to investigate the impact of implementation of the 13th round of MDA in two Egyptian villages in the Menoufyia Governorate area after failing the transmission assessment survey (TAS) in 2005 using two methods, and to decide whether it is safe to stop MDA in these, as well as in similar implementation units (IUs). To achieve this aim, both the immunochromatographic card test (ICT) and molecular xenomonitoring (MX) techniques were employed. A cross-sectional study was carried out in the villages in 2014 with two sections: Section (1): a school-based survey where all the primary school entrants (6-7) years of age were tested by ICT. Section (2): a mosquito-based survey where a total of 152 mosquito pools collected from Samalay and 167 from Kafr El-Tarainah were tested for the presence of the gDNA of Wuchereria bancrofti microfilaria by real-time PCR assays. The results revealed that all primary school children in both villages were 100% negative for antigenemia. Also, all mosquito pools were 100% negative for the microfilarial gDNA.

A Comparative evaluation of diagnostic performance of Immunochromatographic Rapid Card Test for malarial antigen against Peripheral smear Microscopy

Background: Malaria poses a major public health problem in India and has emerged as a biggest health burden in terms of morbidity and mortality. Rapid detection of malarial parasite can ensure the prompt timely and efficient management of clinical cases and control of the disease. Objectives: To evaluate the diagnostic performance of Immunochromatographic Rapid Card Test (ICT) for malarial antigen against Peripheral smear microscopy for diagnosing Malaria. Materials and Methods : This Cross sectional study was conducted in Dept. of Microbiology of a Rural tertiary care teaching hospital of Western Uttar Pradesh from January 2016 to August 2016. Eight Hundred thirty seven patients with clinical suspicion of malaria whose samples were sent on advice by clinicians to the Microbiology laboratory for the peripheral smear microscopy and Rapid card test for malarial antigen were included in this study after obtaining clearance from Institutional Ethics committee. Results : Out of the 837 blood samples tested, 106(12.66%) samples tested positive for malaria by Peripheral smear microscopy and 109(13%) by ICT Rapid card tests. The sensitivity of ICT for non-falciparum malaria (82.65%) came out to be lower than that for falciparum malaria (87.5%). The specificity of ICT for non falciparum malaria (98.9%) was almost same as for falciparum malaria (99.3%).The accuracy of ICT for falciparum malaria (99.16%) was slightly higher than for non-falciparum malaria (97%). Conclusion: This study suggests that ICT Rapid card test couldnt replace PS microscopy completely, but can be used as an alternative or complimentary to microscopy, particularly in resource constrained remote rural areas of India.