Rapid Card Test Research Articles

Trends of coinfections among healthy blood donors: COVID-19 pandemic repercussion

ABSTRACT Background: Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) coinfection has emerged as a leading cause of morbidity throughout the world in the last two decades. The coronavirus disease 2019 (COVID-19) pandemic has escalated the disease burden further by increasing the number of intravenous (IV) drug abusers and unemployment. Aim: The present study was done to analyse the impact of COVID-19 on seroprevalence as well as trends during pre, post and pandemic years of coinfection and mono-infections in the Malwa region of Punjab. Setting and Design: This descriptive cross-sectional study was done in the department of immunohematology and blood transfusion at a tertiary care hospital. Materials and Methods: The data on transfusion-transmitted infections (TTIs) was collected for a period of four years from 2019 to 2022, that is, pre, post and during the pandemic period. All the blood samples were screened for viral markers, HIV I and II, HCV, and hepatitis B surface antigen (HBsAg) using the enzyme-linked immunosorbent assay (ELISA) technique. Malarial antigen and syphilis infection testing was done using a rapid diagnostic card test. The total number of sero-reactive cases and their distribution were noted. Results: A total of 58,953 donors were screened and included during the study period. Each blood donor was identified by a donor registration number. The overall TTI seroprevalence in blood donors was 2.83% (n = 1670). The seroprevalence of TTIs in blood donors showed an increasing trend for HIV, HCV, and HBsAg in 2019–2021, whereas there was a decrease in reactivity status in the 2022 (back to pre-pandemic year). There was a significant increase in the coinfection rate from 0.1% to 0.25%. Conclusion: The COVID-19 pandemic impact on the coinfection rate of TTI was significant. To curb these TTIs and coinfections, education and public awareness are the key factors. India is a developing country, so transfusion medicine specialists need to work day and night to practice safe blood services.

Comparative analysis of treponemal specific chemiluminescence test and rapid card test for screening of syphilis in blood donors – A tertiary center study

Abstract: BACKGROUND: Screening for transfusion-transmitted infections (TTIs) is an important step for the safety of blood transfusion. Major TTIs for which screening is done are hepatitis B surface antigen, antibody to hepatitis B virus, hepatitis C virus, human immunodeficiency virus, syphilis, and malaria. The aim of this study was to compare the diagnostic accuracy of treponemal-specific chemiluminescence test and rapid card test for the screening of syphilis by taking Treponema pallidum hemagglutination assay (TPHA) as a gold standard test. MATERIALS AND METHODS: This was a cross-sectional study. All the routine blood donors were screened according to the National Blood Transfusion Council guidelines. One hundred and twenty syphilis serology-positive samples were obtained either by rapid card test immunochromatographic test/chemiluminescence assay or both. These samples were further tested by TPHA (gold standard test). Statistical analysis was done using the Mcnemar test, DeLong et al. test, and Chi-square test P < 0.05 was considered statistically significant. RESULTS: The sensitivity and specificity of both chemiluminescence and rapid card test were comparable (P < 0.0001) and the diagnostic accuracy of chemiluminescence and rapid card test was 95.83% and 94.58%, respectively. CONCLUSION: Both chemiluminescence and rapid card tests show comparable performance, so it is concluded to use rapid card test as a reliable backup in remote areas, peripheral blood bank setup, and in emergency situations where timesaving is lifesaving.

Olfactory Dysfunction as a Marker for Cognitive Impairment in General Paresis of the Insane: A Clinical Study.

BACKGROUND General paresis of the insane (GPI) is characterized by cognitive impairment, neuropsychiatric symptoms, and brain structural abnormalities, mimicking many neuropsychiatric diseases. Olfactory dysfunction has been linked to cognitive decline and neuropsychiatric symptoms in numerous neuropsychiatric diseases. Nevertheless, it remains unclear whether patients with GPI experience olfactory dysfunction and whether olfactory dysfunction is associated with their clinical manifestations. MATERIAL AND METHODS Forty patients with GPI and 37 healthy controls (HCs) underwent the "Sniffin Sticks" test battery, Mini-Mental State Examination, and Neuropsychiatric Inventory to measure olfactory function, cognitive function, and neuropsychiatric symptoms, respectively. Brain structural abnormalities were evaluated using visual assessment scales including the medial temporal lobe atrophy (MTA) visual rating scale and Fazekas scale. RESULTS Compared with HCs, patients with GPI exhibited significant olfactory dysfunction, as indicated by deficits in the odor threshold (OT) (P=0.001), odor discrimination (OD) (P<0.001), and odor identification (OI) (P<0.001). In patients with GPI, the OI was positively correlated with cognitive function (r=0.57, P<0.001), but no significant correlation was found between olfactory function and neuropsychiatric symptoms, blood, or cerebrospinal fluid biomarkers (rapid plasma reagin circle card test and Treponema pallidum particle agglutination test), or brain structural abnormalities (MTA and Fazekas scale scores). Mediation analysis indicated that the impaired OI in patients with GPI was mediated by cognitive impairment and impaired OT respectively. CONCLUSIONS Patients with GPI exhibited overall olfactory dysfunction. OI is correlated with cognitive function and the impaired OI is mediated by cognitive impairment in patients with GPI. Thus, OI may serve as a marker for reflecting cognitive function in patients with GPI.

Performance Evaluation of Determine HBsAg 2 Rapid Card Test for the Detection of Hepatitis B Surface Antigen in Clinical Samples.

Hepatitis B virus is one of the leading underlying causes of chronic liver disease. Rapid diagnostic tests with improved sensitivity and specificity for detecting hepatitis B infection could aid in large-scale community screening in resource-limited settings. This study was designed to assess the clinical performance of a rapid card test to detect HBsAg. In this study, archived once-thawed serum samples were tested on the Determine HBsAg 2 card and their performance was evaluated in reference to a chemiluminescence-based assay (HBsAg qualitative assay, Abbott Diagnostics, US). A total of 120 patient samples (46 confirmed HBsAg-positive and 74 confirmed HBsAg-negative) were used in this study. The overall median age of the study population was 44 years (IQR: 36-51 years), with a male gender predominance (90%). A specificity of 100% (74/74) and sensitivity of 84.7% (39/46) was observed for the Determine HBsAg 2 assay compared with the reference assay. The samples that showed false-negative results (n = 7) by the card test had HBsAg levels below the limit-of-detection of the card assay. The Determine HBsAg 2 assay gives rapid results in 15 minutes with good sensitivity and specificity. This makes it a good, affordable tool for large-scale screening and public health surveillance programs. Accurate and cost-effective rapid card tests for early detection of Hepatitis B infection would enable quick isolation of infected cases, thus reducing transmission in the community. Samal J, Soni A, Pandey A, et al. Performance Evaluation of Determine HBsAg 2 Rapid Card Test for the Detection of Hepatitis B Surface Antigen in Clinical Samples. Euroasian J Hepato-Gastroenterol 2024;14(1):9-11.

CLINICAL AND LABORATORY PROFILE OF ADMITTED PATIENTS PRESENTING WITH FEBRILE ILLNESS DUE TO DENGUE AND SCRUB TYPHUS COINFECTION FROM A TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN, INDIA

Objective: The present study aims at describing the clinical features, laboratory diagnosis, and complications in patients presenting with febrile illness due to scrub typhus and dengue coinfection from Southern Rajasthan, India. Method: This present prospective, observational, and hospital-based study conducted in the Department of Microbiology of AIMS &amp; RC, Rajsamand, located in Southern Rajasthan, from January 2021 to December 2021. Scrub typhus was diagnosed in the microbiology laboratory by performing SD Bioline, one-step scrub typhus for the detection of IgM antibody, and dengue fever using J.mitra and Co. Pvt. Ltd., rapid card test for the detection of NS1 antigen and IgM antibody. Result: Out of 500 patients suspected of AUFI, 25 (5%) patients diagnosed of having dengue and scrub typhus coinfection. Fever was present in all 25 (100%) patients and 13 (52%) of patients had arthralgia, nausea, and vomiting. The most common sign noticed in our study was pallor and icterus in 10 (40%) patients each followed by shock/hypotension in 8 (32%) and hepatosplenomegaly in 5 (20%). The most predominant laboratory finding was thrombocytopenia (&lt;1.0 × 106/cumm) in 23 (92%) patients, while elevated bilirubin (&gt;2 mg/dl) in 22 (88%) and elevated transaminase and prolonged aPTT in 21 (84%) patients each. The majority of patients 23 (92%) had hepatic dysfunction, i.e., in followed by multi-organ dysfunction (MODS) in 15 (60%). Conclusion: In developing countries like India, particularly in tropical areas, dengue, and scrub typhus coinfection is under-recognized entity. Additional investigation should be carried out in cases of AUFI patients with features such as hypotension, leukocytosis, early drop in platelet counts, and hypoalbuminemia.

Characteristics of Hepatitis B Virus, Hepatitis C Virus, and Syphilis Coinfection in People With HIV/AIDS Contracted Through Different Sources: Retrospective Study.

The burden of hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis coinfections remains disproportionately high among people living with HIV/AIDS. Hubei province is located in central China, where there are distinct regional characteristics of the distribution of people living with HIV/AIDS acquired via diverse transmission routes and the AIDS epidemic itself. We aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission. From January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men. Among 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission. In people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.

Sars-cov-2 and denv co-infection: Diagnostic challenge and curse on overloaded health care system

Co-infection with dengue is posing a diagnostic challenge in dengue-endemic countries because of similar clinical symptoms &amp; laboratory findings between COVID 19 and Dengue infection. This co-infection is a warning for dengue endemic regions to face the challenge of differentiating and managing two disease entities together as both show serological cross reactivity which can mislead the timely diagnosis and treatment and is associated with increased mortality. And if timely diagnosis is not made, it will spread the virus to other people as timely isolation will not be done.: Present study aimed to determine the prevalence of COVID-19 &amp; dengue co-infection in a tertiary care centre and to compare the laboratory findings among patients of COVID-19, dengue and co-infection cases. : This cross-sectional study was conducted in the Department of Microbiology, SMSR, Sharda Hospital and University. : This cross-sectional study was done on COVID-19 positive patients and dengue positive patients over the period of four months. Nasopharyngeal/ oropharyngeal swabs were subjected to RT-PCR for COVID-19 infection and serum samples of the patients were used for performing rapid card test for dengue infection. : The statistical analysis was performed with SPSS Software (Statistical Package for Social Sciences) and presented in form of tables and graphs. P&amp;#60;0.05 was considered as statistically significant. Out of 45 cases with COVID-19 &amp; DENV co-infection, age group 40-70yrs constitute 62.2% of cases. 24.4% (11 patients) out of 45 co-infection patients showed leucopenia. 62.2% (28 patients) out of 45 co-infection patients showed lymphopenia. 64.4% (29 patients) out of 45 co-infection patients showed increased levels of D-Dimer. 48.9% (22 patients) out of 45 co-infection cases developed thrombocytopenia. : In dengue-endemic regions like India overlapping out-breaks of dengue &amp; COVID-19 infection, poses a challenge for accurate diagnosis &amp; treatment because of similarities in clinical symptoms and laboratory findings.

Comparative Evaluation of Rapid Card Test And Enzyme Linked Immunosorbent Assay For The Detection Of Hepatitis B Surface Antigen In A Tertiary Care Hospital

Background: Hepatitis B virus (HBV) infection is one of the leading causes of death in developing countries. The most importantmarker for HBV diagnosis is detection of Hepatitis B surface antigen in blood.Objective: The aim of this study was to compare the analytical sensitivity of a rapid card test in comparison to Enzyme-LinkedImmunosorbent Assay (ELISA) which is considered a Gold Standard technique for the detection of HBsAg in blood samplesreceived for HBsAg test in serology section of Microbiology Department, Central Laboratory, Sharda Hospital.Methods: Cross-sectional observational study was conducted at the Department of Microbiology, School of Medical Sciences &amp;Research for a period of 12 months from 1st November 2020 to 31st October 2021. The two different brands by which multipleparameters were analyzed were HEPACARD and Erba Lisa SEN HBsAg.Results: A total of 13939 blood samples were received for HBsAg diagnosis. For the study purpose, from the total of 13939samples, 386 were randomly selected to be included in the study with 193 positive samples and 193 negative samples. Thesensitivity and specificity of Rapid card were 95.83% and 100% respectively. The Positive predictive value and Negativepredictive value of Rapid card were 100% and 95.65% respectively for HBsAg detection.Conclusion: It can be concluded that, an ideal rapid test is a boon in time-saving situations. Since HBsAg screening by a rapidtest is easier, cost effective, time saving can be easily performed by any trained health care worker at any time of need. Hence,HBsAg screening can be preferable done by a Rapid card test followed by a supplemental ELISA and Polymerase chain reactionfor further confirmation. Good sensitivity and specificity of Immuno-chromatography test (ICT) for early detection of HBsAgwas observed.

Seroprevalence and incidence of primary dengue infection and its correlation with fetomaternal prognosis in Western Rajasthan.

Viral hemorrhagic fevers are becoming increasingly common in the tropics and subtropics. Dengue fever is currently the most important arthropod-borne viral disease because of its widespread distribution in more than 100 countries and its potential for extensive outbreaks of life-threatening disease. This study was a hospital-based cross-sectional study conducted in the Microbiology Laboratory of Maternal and Child Tertiary Care Hospital in Western Rajasthan, India, between January 2021 and December 2021. Institutional Ethical Committee permission was obtained. All patients with clinical suspicion of dengue-like illness (DLI), attending outpatient department (OPD) or inpatient department (IPD), were included in the study after obtaining their written consent. A blood sample was collected, and the Dengue Duo rapid card test was conducted for the detection of nonstructural protein 1 (NS1) antigen and immunoglobulin (Ig) M or IgG antibody estimation. All positive samples were tested for IgM enzyme-linked immunosorbent assay (ELISA) test using MAC-ELISA. Of 250 positive sample, the distribution of cases as per clinical features was as follows: all cases presented with fever (100%) followed by myalgia (24.5%), headache (16.06%), hemorrhagic manifestation (13.25%), rash (8.84%), and bleeding gums (2.01%). Thrombocytopenia was seen in 30.40% (76/250) of dengue fever cases. NS1 antigen was detected in 157 cases (62.80%) followed by IgG in 84 cases (33.60%), IgM in 77 cases (30.80%), NS1+IgG in 27 cases (10.80%), NS1 + IgM in 16 cases (6.40%), and NS1 + IgM + IgG in five cases (2%). Of 250 samples, 77 cases were IgM positive and 173 were IgM negative by the Dengue Duo card test. Among the 173 Dengue Duo IgM card negative, 131 cases (79.39%) were also detected negative by IgM ELISA and 42 cases (49.41%) were detected positive by IgM ELISA. The sensitivity was 50.59%, the specificity was 79.39%, the positive predictive value (PPV) was 55.84%, the negative predictive value (NPV) was 75.72%, and the diagnostic accuracy was 69.90%. The case fatality of the cases was 2.35%. Early diagnosis and treatment can prevent mortality in pediatric and pregnant females suffering from dengue and dengue-like illness. Facility and availability of ELISA kits should be adequate for early confirmation of suspected dengue patients by ELISA test.

COMPARISON OF ANTIBODY DETECTION BY RAPID DIAGNOSTIC KIT AND ELISA TEST FOR DIAGNOSIS OF HEPATITIS C VIRUS INFECTION

Background: Hepatitis C virus (HCV) infection is a major cause of healthcare problem along with burden of health management care cost of international concern. Hepatitis C is a serious threat with long term complication. The present study is undertaken to compare rapid card test based on Immunochromatography principle with ELISA test for detection of anti HCV antibodies. In the absence of vaccine, primary prevention of Hepatitis C should be targeted to reduce transmission of virus. High risk people should be provided with education, counselling and screening. A cross-sectional study was done at Dept. of Microbiology, M.G.M.M.C, Indore Method: for one year comprising of 500 samples after getting Institutional Scientic Research and Ethics Committee approval. Rapid card and ELISA tests were performed in the samples received for detection of Anti-HCV ab. Out of 500 blood samples test Result: ed on Rapid card 22 were positive while 478 were negative. Further testing on same 500 samples with ELISA test 22 were positive and 478 were negative. Discussion: Present study ndings suggest that for screening of anti HCV antibody ELISA and Rapid card tests both can be used as diagnostic tool depending upon facilities available in the laboratory. Rapid card Conclusion: tests were found to be equally diagnostic as compared to ELISA test and hence can be recommended in screening of HCV

CLINICO-DEMOGRAPHIC PROFILE AND SEROPREVALENCE OF DENGUE AT A TERTIARY CARE HOSPITAL - CENTRAL INDIA

Background: Dengue virus infection has been a major public health problem over the past decades. The disease is endemic in many parts of India. Mortality is high when dengue manifests as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Early diagnosis and treatment greatly help prevent complications. Aim: The study was aimed to determine the clinic-demographic, and seroprevalence of dengue infection among patients attending Government Medical College and Hospital, Nagpur, Maharashtra during the period from January 2021 to December 2021. Methods: In a retrospective study from Jan 2021-December 2021 blood samples were withdrawn from patients with fever. Samples were tested with BeneSphera Dengue NS1 and Dengue IgG/IgM Rapid card test (Lateral ow). Results: Serodiagnosis of dengue at tertiary care hospitals was 23.44% (1062/4530). The most affected group was 21-30 years old. Men (64.08%) were more affected. Common features were fever 1062 (100%), headache 508 (52%), body aches 205 (21%), vomiting 205 (21%), itching 68 (7%), rash 29 (3%). Of the 1062 dengue-positive cases, 998 (93.97%) were NS-1 positive, 18 (1.69%) were IgM positive, 21 (1.97%) were IgG positive, and 25 (2.35%) were NS1+. was IgM positive. Dengue cases peaked in August. Conclusions: The dependability of Immunochromatographic test makes it an excellent tool for early diagnosis and treatment. Dengue cases were more during August, so it is useful to plan special preventive strategies to prevent the outbreaks.

Pulmonary Manifestations of Dengue Fever Section at a Tertiary Care Centre in Northern India: A Cross-sectional Study

Introduction: Dengue Fever (DF) is associated with systemic inflammation, clinically manifesting as involvement of different organ systems, including the pulmonary system. Pulmonary involvement is characterised by pleural effusion, pneumonia, haemoptysis, pulmonary haemorrhage, secondary bacterial infections with Acute Respiratory Distress Syndrome (ARDS), and Dengue Haemorrhagic Shock Syndrome (DHSS), which are the leading causes of mortality and morbidity. Aim: This study aims to analyse the pleuropulmonary manifestations associated with DF. Materials and Methods: This cross-sectional study was conducted at a tertiary care centre in northern India from June 2018 to November 2018. A total of 140 patients diagnosed with DF using Non-Structural protein 1 (NS1), Immunoglobulin (Ig)M, (Ig)G rapid card tests and confirmed by Enzyme-Linked Immunosorbent Assay (ELISA) were included. Patients were examined for pleuropulmonary manifestations and other systemic features. Baseline investigations, including Complete Blood Count (CBC), Haematocrit (Hct), Liver Function Test (LFT), Renal Function Test (RFT), chest X-ray (PA view), and HighResolution Computed Tomography (HRCT) of the chest when required, were performed. Data analysis was carried out by using Statistical Package for Social Sciences (SPSS) version 25.0. Results: A total of 140 patients (108 males and 32 females) aged between 18 and 35 years were included and analysed. Among them, 113 (81%) were diagnosed with uncomplicated febrile illness, 17 (12%) with Dengue Haemorrhagic Fever (DHF), and 10 (7%) as Dengue Shock Syndrome (DSS). Patients with co-morbidities, particularly respiratory system illnesses, and young patients were found to be at increased risk of morbidity. Pleuropulmonary manifestations observed in the study included pleural effusion, pneumonia, pulmonary haemorrhage, ARDS, and pneumothorax. Conclusion: DF is associated with the involvement of the pulmonary system, and its incidence is increased in cases of moderate to severe disease. Therefore, pleuropulmonary manifestations can be useful in evaluating the severity of DF cases.

Prevalence of malaria: A 7-year trend analysis from a tertiary care center, Puducherry.

Battle against malaria has been going on since time immemorial. Understanding the true burden of disease and the determinants of its transmission are important for implementing adequate control measures. This study intends to explore the local epidemiology and burden of malaria in Puducherry, a coastal Union territory located in the Southern part of India over a period of 7 years. A retrospective record-based study was conducted from 2015 to 2021, where details from all samples that tested positive for malaria by peripheral blood examination or rapid card test, from suspected cases were collected and analyzed. The overall prevalence of malaria over the 7 years was 1.7% (257/14,888). Majority of the patients were male (75.88%) and the major age group affected was from 21 to 40 years (56.03%). The disease was maximum seen during the monsoon season followed by the post-monsoon season. Vivax malaria predominated irrespective of the gender, seasonal change, and different age groups except in children <10 years was both falciparum and vivax malaria were seen in equivalence. The major species to cause infection among infants were Plasmodium falciparum (3/4). This study shows a declining trend of malaria transmission over the years. There is no change in the predominant species affected or seasonal trends over the years. The possibility of underestimation of cases due to various factors cannot be ignored.

Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies Response in COVID-19 Patients and Health-Care Workers

Background: COVID-19 epidemic causes destructive consequences on human beings and on the global economy. Aim: The purpose of this study was to evaluate the severe acute respiratory syndrome coronavirus 2 antibodies response in COVID-19 patients and health-care providers to them in different categories and with respect to age, sex, and symptoms. Materials and Methods: Analysis of immunoglobulin (Ig) G and total COVID antibodies was done by chemiluminescent microparticle immunoassay (CMIA) and IgM antibodies by rapid card test method in 300 cases. Results: Out of 300 cases, asymptomatic were 29%, mild 26.66%, moderate 17.66%, and severe were 28.33%; percentage of males were higher than females in all. The most common age group involved was 30–40 years (20%). The most common symptom was fever (51.33%), followed by cough (38.66%), and the most common comorbidity was hypertension (16.33%). We observed that severe category had a higher percentage of symptoms as well as comorbidities. Out of 300 cases, 56.66% were IgG positive, and 89.6% were total COVID antibody positive. In rapid IgM antibodies, out of 50 cases, 13 were positive. We observed that IgM was positive mainly in severe cases compared to mild cases, while IgG level was lower in severe cases than those of mild cases. In our study, majority of cases (97 cases) are IgG positive approximately in 8–14 days after onset of symptoms. Conclusion: Quantitative analysis of antibodies is a simple, quick, and cheap method and could play major role in diagnosis and prognosis of COVID-19, and also used to pick up silent carriers (asymptomatic patients) who missed in false-negative reverse transcription polymerase chain reaction in such epidemic.

Blood Donation Screening of Transfusion-Transmissible Viral Infection Using Two Different Nucleic Acid Testing (NAT) Platforms: A Single Tertiary Care Oncology Centre Experience.

Nucleic acid testing (NAT) is used to screen transfusiontransmittable infections (TTIs) in donated blood samples and provide an additional layer of blood safety. In this study, we describe our experience in screening viral TTIs using two formats of NAT: cobas® MPX2 polymerase chain reaction- based minipool NAT (PCR MP-NAT) and Procleix Utrio Plus transcription-mediated amplificationbased individual donor-NAT (TMA ID-NAT). Data routinely collected as a part of blood bank operations were retrospectively analysed over a period of 70months for TTIs. Blood samples were initially screened for HIV, HBV, HCV, syphillis by chemiluminescence and malaria by Rapid card test. In addition to serological testing, all samples were further screened by TMA-based ID-NAT (ProcleixUltrio Plus Assay) during Jan 2015-Dec 2016, and by PCR-based MP-NAT (Cobas® TaqScreen MPX2) during Jan 2017-Oct 2020. RESULTS: A total of 48,151 donations were processed over 70months, of which 16,212 donations were screened by ProcleixUtrio Plus TMA ID-NAT and 31,939 donations by cobas® MPX2 PCR MP-NAT. Replacement donors and male donors outnumbered voluntary donors and female donors respectively. The overall NAT yield rate of MP-NAT was 1:2281 compared to 1:3242 with ID-NAT, during the respective time period. ID-NAT detected 5 HBV infections missed by serology, whereas MP-NAT detected 13 HBV infections and 1 HCV infection missed by serology. The proportion of donations that were both seroreactive and NAT reactive was higher with MP-NAT (59.8%) compared to ID-NAT (34.6%). Cobas® MPX2MP-NAT had higher overall NAT yield rate compared to ProcleixUtrio Plus ID-NAT and confirmed a higher proportion of seroreactive donations. Due to the ease of operation, simple algorithm, cobas® MPX2 PCR based MP-NAT can be an effective solution for blood screening in India.

A PROSPECTIVE STUDY TO KNOW THE TRENDS OF SCRUB TYPHUS INFECTION DURING THE SEASONAL OUTBREAK AT A TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN, INDIA

Scrub typhus is a rickettsial disease caused by the organism Orientia tsutsugamushi. The overall mortality varies from 7% to 30%, next only to malaria among infectious diseases5. This prospective study was conducted with an aim to know the prevalence of the disease, sex ratio signicance and impact of seasons in the disease outcome in Rajsamand, Rajasthan. A total of 515 samples were received from different clinical departments at Ananta Institute of Medical Sciences and research center, Rajsamand from December 2020-December 2021, in which 88 samples were IgM Antibody reactive by Rapid card test and positivity is 16.7%. Scrub typhus infection was found comparatively more in female patients i.e., 48[55%] than in male patients 40 [45%]. The female to male ratio was 1.2:1. In the present study, majority of the patients 29 (32%) were from the age group of 31-45 yrs and about 19 (22%) were between 16-30 yrs. Maximum cases 31(35%) had occurred in the month of September followed by 27(31%) in October, 21(24%) in November and 4(5%), 3(3%), 2(2%) in the month of August, July and December 2021 respectively and not a single case reported in the month of December 2020 and from January 2021 to June 2021. So, scrub typhus should always be considered in the list of differential diagnosis of a young febrile female patient of this region mainly during the end of rainy season. This will help in proper diagnosis, timely and adequate treatment and avoidance of complications which are associated with high mortality

SEROPREVALENCE OF TRANSFUSION TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS AT A TERTIARY CARE TEACHING HOSPITAL IN AJMER, RAJASTHAN: A 5 YEAR STUDY

Objective: The objective of the study was to study the seroprevalence of TTIs (transfusion transmissible infections) among blood donors from the records (June 2017–May 2022) at blood center, JLN Hospital and associated group of Hospital, Ajmer, Rajasthan. Methods: A cross-sectional study was carried out over a period of 5 years from June 2017 to May 2022. Serum samples were screened for hepatitis B virus (HBV), hepatitis C virus (HCV) (III generation ELISA), antibodies to human immunodeficiency virus (HIV) Type 1 and 2 (IV generation ELISA kits), Syphilis and Malaria parasite using modified Treponema pallidum hemagglutination test and rapid card test, respectively. Results: A total of 75,034 healthy donors were included out of which majority of donors were male (97.4%). The overall seroprevalence of HIV, HBV, HCV, Syphilis, and Malaria were 0.07%, 0.71%, 0.06%, 0.29%, and 0.05%, respectively. Conclusion: Methods to ensure a safety blood supply should be encouraged. The increase in public awareness regarding voluntary blood donation, meticulous donor screening, counseling and use of highly sensitive tests can help in reducing the risk of TTIs.

Assess the changes in hematological parameters in dengue and malaria fever

Introduction: Dengue fever is the most common cause of arboviral disease. Dengue fever presents with confusing clinical profile and dengue is diagnosed by reverse transcription polymerase chain reaction. Hematological parameters like platelet count, hematocrit, leucocyte count and peripheral smear findings will aid in the diagnosis of dengue fever whereas malaria which is responsible for Leukemia, anemia and thrombocytopenia. Method: Total number of cases was 138. Out of which 121 Dengue IgM positive cases and for Malaria 107 rapid card test positive and smear positive cases were selected. period of 1 year. Jan 2020 to Sep 2021. Result: dengue incidence is 66.10% up to 30yrs of age group, where as in Malaria incidence is 60.90%. Dengue is more common in females(64.50)% than Males(35.50%) as compared to malaria. Reduction in RBC count less than 4 million is more common in malaria (48.76) than dengue (48.76%). anemia is more common in malaria(74.76%) compared to dengue(46.23%). Conclusion: Raised hematocrit, thrombocytopenia, leucopenia, and atypical lymphocytes in the peripheral smear will aid in the early diagnosis of dengue infection. Hematological changes and their diagnostic values in malaria infected patients found out that hemoglobin levels, white blood cell counts, and platelet counts were significantly reduced.

Assessment of Plasmodium falciparum histidine rich protein 2 and /3 (pfhrp 2&/ pfhrp 3) gene deletion or mutation in Plasmodium falciparum positive blood samples in a tertiary care centre in South India.

Rapid diagnostic card tests (RDTs) enable timely and appropriate diagnosis of malaria especially in remote areas. Plasmodium falciparum histidine rich protein 2 (PFHRP2) is the most targeted antigen for the detection of Plasmodium falciparum infections by rapid diagnostic card test. Genetic mutations and gene deletions are important emerging factors for false-negative RDTs, which may delay the provision of life-saving treatment for the patients. Hence, we would like to evaluate for the existence of pfhrp2/3 gene deleted P. falciparum parasites in our health care setting. This study was conducted for a period of 2years in a tertiary care centre in South India. Blood samples that are microscopically confirmed as P. falciparum but negative by RDT were assessed for the presence of pfhrp2, pfhrp3, and their flanking genes using conventional PCR. Follow up of the clinical outcomes were also done for these patients. Of the 63 positive samples collected (50 /63) 79.4% were P.vivax and (13/63) 20.6% were P.falciparum by PCR. Among the 13 P. falciparum positive samples, 4 samples (4/13), (95% CI -10.36% to 61.11%) were found to be RDT negative but microscopically positive.Pfhrp2,pfhrp3 and their flanking genes were amplified for these 4 samples. All 4 samples were found to be negative for both pfhrp2-2 & pfhrp2-3 exon regions and also varying patterns of flanking gene deletions were also noted.This study provides molecular evidence for the existence of pfhrp2 & pfhrp3 deleted P. falciparum parasites in a tertiary care centre in South India warranting periodic evaluation of pfhrp2 based RDT use. Only pfhrp2/3 RDT based decision on diagnosis of P.falciparum malaria should always be reconsidered especially in remote areas.

Case report on typhoid fever

An Eight-year-old boy with high grade fever, abdominal pain and vomiting suspected for typhoid and diagnose by serological test (rapid card test), urine analysis and blood culture were also performed. Rapid card test is very helpful for the detection of IgG and IgM antibodies present in the body in 15-30 minutes of time. With rapid card test and blood culture the patient was diagnosed with typhoid fever. The Ceftriaxone antibiotic was given to patient intravenously for 5 days and the patient recovered. Keywords: enteric fever; typhoid fever; blood culture; serology for typhoid.