Rapid Diagnostic Kits Research Articles

Diagnostic Accuracy of Rapid Diagnostic Kits Test for Diagnosis of Malaria

Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,

Generation of Synthetic Peptide-Specific Antibody for the Development of A Southern Rice Black-Streaked Dwarf Virus Diagnostic Test

Southern rice black-streaked dwarf virus (SRBSDV) causes severe epidemical disease on rice with the infected area up to millions of hectares in South China and North and Central of Vietnam. So far, there are no effective, cheap, quick, and practicable methods for diagnosing SRBSDV. The conventional RT-PCR technique is the most popular method for detecting SRBSDV with high accuracy. However, it is hard to apply this method for large-scale SDBSDV diagnosis because of the requirements of expensive reagents and instruments, as well as complex procedures. Meanwhile, SRBSDV diagnostic techniques based on antigen detection have outstanding advantages due to their low cost, easy manipulation, and wide application possibility. Today, there are still no commercially available specific antibodies to SRBSDV. In a previous study, to develop the SRBSDV diagnostic technique by the ELISA technique, a SRBSDV specific antibody was generated by a recombinant P10 envelope protein (66kDa), which has a titer of 1:5,000. In this study, we continued to study the production of SRBSDV specific polyclonal antibodies from small antigen–rich peptides from the SRBSDV P10 envelope protein. The resulting purified antibody can specifically bind to the P10 protein and at the diluted concentration of 1:100,000 it can detect SRBSDV in infected rice samples via the dot-blot technique. Our research results open up new opportunities for proactive antibodies to develop a SRBSDV membrane rapid diagnostic kit.

Assessing the Performance of CareStart™ Malaria Rapid Diagnostic Tests in Northwest Ethiopia: A Cross-Sectional Study.

Background While rapid diagnostic tests are an alternative diagnostic tests for microscopy in the diagnosis of malaria in rural settings, their performance has been inconsistent. Performance of rapid diagnostic tests might be affected by manufacturing process, transportation and storage, parasitemia level, and skill of personnel who perform the tests. Therefore, periodic evaluation of the local field performance of rapid diagnostic tests is mandatory in order to make early corrections in case of decreased performance. Methods A facility-based cross-sectional study was conducted from January to May 2020 among 257 malaria-suspected patients attending selected health centers in Bahir Dar Zuria district. Capillary blood was collected from each participant and tested for Plasmodium infection by CareStart™ rapid diagnostic test kit and thin and thick blood film microscopy. Data were analyzed using statistical software for social sciences version 20 and MedCalc software version 19.3. Sensitivity, specificity, positive and negative predictive values, and kappa value were calculated to evaluate the performance of rapid diagnostic tests against microscopy. Results Among 257 study participants, 47 (18.3%) were tested positive for Plasmodium infection by at least one of the diagnostic methods. Rapid diagnostic tests revealed 3 false positive and 3 false negative results. The sensitivity and specificity of CareStart Malaria Pf/Pv Combo test were 93.2% and 98.6%, respectively (kappa = 0.918). Conclusion CareStart™ rapid diagnostic test has comparable performance with microscopy for malaria diagnosis. We recommend continued use of CareStart Malaria Pf/Pv Combo test at health posts in Ethiopia where microscopy is not available.

Detection of Genetic markers associated with Plasmodium falciparum drug resistance among malaria patients in Kaduna State, Nigeria

Malaria is a disease of public health concern in Nigeria and sub-Saharan Africa. It is caused by intracellular parasites of the genus Plasmodium. The aim of this study was to detect genetic markers associated with Plasmodium falciparum drug resistance among malaria patients in Kaduna State, Nigeria. The study was a cross-sectional study that lasted from May 2018 to October 2018. Three hundred blood samples were collected from consenting individuals attending selected hospitals, in the three senatorial districts of Kaduna State, Nigeria. Structured questionnaire were used to obtain relevant data from study participants. The blood samples were screened for malaria parasites using microscopy and rapid diagnostic test kit. Polymerase Chain Reaction was used for detection of the drug resistance genes. Pfcrt, pfmdr1, pfdhfr, pfdhps and pfatpase6 genes were detected at expected amplicon sizes from the malaria positive samples. The pfatpase6 PCR amplicons were sequenced and a phylogenetic tree was created to determine their relatedness. Result showed that Pfcrt (80%) had the highest prevalence, followed by pfdhfr (60%), pfmdr1 (36%) and pfdhps (8%). Pfatpase6 was also detected in 73.3% of the samples, and a phylogenetic tree showed relatedness between the pfatpase6 sequences in this study and those deposited in the GenBank. In conclusion, the study detected that Plasmodium falciparum genes were associated with drug resistance to commonly used antimalarials.

Seroprevalence of hepatitis b, c and HIV among patients attending a multispecialty hospital: An 8 year old retrospective study

Background: Hepatitis B, Hepatitis C and HIV infection are serious global health problems. Many risk behaviors as well as the routes of transmission for HBV and HCV infections are identical to those for HIV and other sexually transmitted diseases. They are considered as occupational risk for dental professionals and other health care workers of getting HIV, HBV or HCV infection from an infected patient and the potential transmission to susceptible patients from infected dental personnel. Due to lack of knowledge regarding the prevalence of these viral diseases among the local populations, this study was aimed to determine the prevalence of HBV, HCV and HIV by detecting the presence of HBV antigen (HBsAg) and HCV antibodies (HCV-Ab) and HIV antibodies (HIV-Ab) and the relation of their presence with other factors such as gender and age among dental patients visiting a tertiary care teaching hospital in Moradabad city in Uttar Pradesh. Materials and Methods: Case records of a total of 3000 patients were included whose serum was screened using Rapid card diagnostic kits using standard recommended procedure. HIV TRI-DOT for HIV antibodies, HEPACARD for HBsAg and HCV TRI-DOT for HCV antibodies. All rapid test positive samples were further tested by a third-generation Enzyme linked immune sorbent assay (ELISA). Data was analyzed and put for statistical analysis. Results: The overall seroprevalence of the HIV, HBV and HCV increased over the eight year period by approximately 5%. A statistical significant difference in prevalence of HIV, HCV and HBV in male and females was obtained. A high seropositivity was prevalent in the age group of 30-40 years. Conclusion: The sero frequency of HIV, hepatitis B and C was high among patients especially from rural population visiting the tertiary health care hospital that usually go unnoticed leading to cross infection. Thus proper history taking, diagnostic tests and sterilization protocols can minimize and prevent these dreadful blood borne infections from spreading.

Management and Prevention of Generalized Herpes Zoster in Elderly Patients in the Convalescent Rehabilitation Ward：A Case Report

A 95-year-old woman was admitted to our hospital for rehabilitation after a subarachnoid hemorrhage, but her physical function deteriorated due to repeated aspiration pneumonia. On the first day of the illness, a painless erythema appeared on the right elbow fossa, and expanded soon afterwards. She developed a fever of unknown origin, which led us to the diagnosis of generalized herpes zoster by using a rapid diagnostic kit. The patient was placed in a private room to prevent nosocomial infection, and we took contact infection prevention measures, such as, restricting the number of staff in the room. Antiviral drugs were administered to the patient, quickly relieving her fever. The erythema became encrusted in about 2 weeks, and private room management was terminated.

Urgency of rapid Legionella detection post-COVID-19 lockdowns: an interview with Elizabeth Minogue.

Urgency of rapid Legionella detection post-COVID-19 lockdowns: an interview with Elizabeth Minogue.

PERSISTENCE OF MALARIALANTIGEN FOLLOWING ANTIMALARIAL CHEMOTHERAPY IN KOLKATA, WEST BENGAL

Early diagnosis and complete treatment is one of the important aspects of malaria elimination programme worldwide. In many areas the diagnosis is based on detection of malarial antigen using commercially available rapid diagnostic kits. The problem remains with persistence of antigen following parasite clearance by proper treatment. The present work was undertaken to study the pattern of persistent antigen of P. vivax and P. falciparum following antimalarial treatment. Atotal of 300 microscopically positive mono-infected with P. vivax (160) and P. vivax (140) patients were recruited, treated with antimalarial drugs and followed up on day 3, 7, 14, 21 and 28 for persistent parasites and antigen. P. vivax specic pLDH antigen was disappeared from peripheral blood within 14 days post treatment period. P. falciparum specic HRP-2 antigen was persisted even after 28 days of treatment. Depending only on antigen based diagnosis, attention should be paid before treatment, particularly in areas with high malaria transmission

Community acceptance, satisfaction, and support for case management of malaria of various degrees in selected rural communities in Ibadan, Oyo-State.

This study aimed to assess communities' perception and adoption of the evidenced-based malaria diagnosis and case management intervention targeted at under-five children. The effectiveness of trained Volunteer Community Health Workers (VCHWs) to diagnose malaria among under-five children using rapid diagnostic testing kit, provide treatment using Artemisinin Combination Therapy and rectal Artesunate were assessed. A qualitative evaluation study was conducted in October 2015. Communities in the 6 rural wards in Ona-Ara Local Government Area, Oyo State Nigeria. Caregivers of under-five children, community-based frontline health workers, and community leaders selected using purposively sampling. Nine Focus Group Discussions and 15 Key Informant Interviews were conducted using a pre-tested guide. Data were subjected to thematic analysis. It was disclosed that VCHWs promoted people's access to prompt and appropriate malaria treatment. The communities accepted the VCHWs; the reasons given for this included the following: effectiveness of VCHWs in case management of malaria; good inter-personal relationship with caregivers; and the positive health outcomes associated with services provided by them. In addition, community members expressed satisfaction with the VCHWs and provided them with all the support needed to function throughout the malaria case management intervention. The VCHWs considered the support as a great source of encouragement. The use of VCHWs to treat malaria was adjudged to be effective and considered acceptable to the communities. The adoption of the intervention and its integration into the primary health system by the government is advocated for in medically underserved rural communities. This work was supported by UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID: A80550 [Nigeria] through funds made available by the European Commission (FP7) for research to improve community access to health interventions in Africa.

Evidence of chikungunya virus infections among febrile patients at three secondary health facilities in the Ashanti and the Bono Regions of Ghana.

BackgroundChikungunya is now of public health concern globally due to its re-emergence in endemic areas and introduction into new areas of the world. Worldwide, the vectors for transmission of the chikungunya virus are Aedes mosquitoes and these are prevalent in Ghana. Despite its global significance, the true burden of chikungunya virus infection in Ghana is largely unknown and the threat of outbreak remains high owing to international travel. This study sought to determine chikungunya virus infection among febrile patients suspected of having malaria infections at some selected health facilities in the Ashanti, Bono East, and Bono Regions of Ghana.MethodologyThis cross-sectional study recruited six hundred (600) febrile patients suspected of having malaria who submitted their clinical samples to the laboratories of the selected health facilities for the diagnosis of their infections. Five to ten millilitres (5-10ml) of venous blood were collected from each study participant. Sera were separated and tested for anti-chikungunya (IgM and IgG) antibodies using InBios ELISA kit following the manufacturer’s instruction. Samples positive for chikungunya IgM and IgG were selected and tested for chikungunya virus RNA using Reverse Transcription-quantitative Polymerase Chain Reaction. Malaria Rapid Diagnostic Test kits were used to screen the participants for malaria. Structured questionnaires were administered to obtain demographic and clinical information of the study participants.ResultOf the 600 samples tested, the overall seroprevalence of chikungunya was 6%. The seroprevalence of chikungunya IgM and IgG antibodies were 1.8% and 4.2% respectively. None of the chikungunya IgM and IgG positive samples tested positive for chikungunya RNA by RT-qPCR. Of the 600 samples, tested 32.3% (194/600) were positive for malaria parasites. Malaria and chikungunya co-infection was detected in 1.8% (11/600) of the participants.ConclusionFindings from the current study indicate low-level exposure to the chikungunya virus suggesting the virus is circulating and potentially causing morbidity in Ghana.

Crispr biosensing and Ai driven tools for detection and prediction of Covid-19

ABSTRACT Coronaviridae family consists of many virulent viruses with zoonotic properties that can be transmitted from animals to humans. Different strains of these viruses have caused pandemic in the past such as Severe Respiratory Syndrome Coronavirus (SARS-CoV) in 2002, Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 and recently Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) also known as COVID-19 in December 2019. Scientists utilised different approaches for the detection and characterisation of CoVs using samples such as serum, throat swabs, nose swabs, nasopharyngeal aspirates and bronchoalveolar lavages. The two common approaches include antigen-based approach and molecular diagnostic approach, which are hindered by limitations such as low sensitivity and requirement for high level of biosafety during isolation of the virus from cell culture. Thus, there is a need for developing a more rapid, sensitive, simple and cheap diagnostic kit for diagnosis of different strains of coronavirus. In this article, we overview 2019 novel coronavirus, pandemic, prior epidemics, diagnosis, treatments, identification of drugs detection based on classification and prediction using artificial intelligence-driven tools. We also overview in-lab molecular testing and on-site testing using CRISPR-based biosensing tools. We also outline limitations of laboratory techniques and open-research issues in the current state of CRISPR-based biosensing applications and artificial intelligence for treatment of Coronaviruses.

Development of a Rapid Diagnostic Kit for Congestive Heart Failure Using Recombinant NT-proBNP Antigen.

Background and Objectives: In patients with congestive heart failure, brain natriuretic peptide (BNP) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) are released due to excessive heart muscle expansion; they can be used for the early detection, progress monitoring, and treatment of congestive heart failure. Recently, considerable efforts have been made to develop an NT-proBNP-based biomarker for detecting heart failure. This study attempts to develop a rapid and accurate congestive heart failure diagnostic kit using NT-proBNP. Materials and Methods: A new gene based on NT-proBNP was selected, recombined, and expressed in Escherichia coli strains, and then monoclonal antibodies were produced using the hybridoma technique. Additionally, antigen-antibody reactivity was confirmed using indirect enzyme-linked immunosorbent assay (ELISA). Furthermore, the first pair and full-strip pair tests were conducted to select candidate clones; these were applied to a rapid diagnosis kit based on gold conjugates and compared with other currently available antigens. Results: NT-proBNP-based antigens with high specificity and monoclonal antibodies were produced, and the optimal antigen-antibody reactivity was confirmed using indirect ELISA. The first pair and full-strip pair tests were performed to select the optimal candidate clones, and a rapid diagnosis kit with excellent reactivity was developed by applying these to a rapid diagnosis kit based on gold conjugates. Conclusions: The development of this rapid diagnosis kit with excellent performance in congestive heart failure is expected to improve disease management by providing an early assessment of the risk of heart failure.

HIV-Associated benign lymphoepithelial parotid cysts: a rare case report

Approximately one to 10% of patients with Human Immunodeficiency virus (HIV) infection associated with salivary gland disease. The presence of Benign lymphoepithelial cyst (BLEC) in the parotid gland is an indicator of HIV Infection. The diagnosis is usually based on a clinical course and HIV confirmatory blood testing. We have reported a case of a 35 years old Nepalese male patient with swelling of the bilateral parotid glands and HIV associated BLEC confirmed by Rapid diagnostic test kit (Determine unigold stat pack).

Burkholderia Pseudomallei Short-Chain Dehydrogenase/ Oxidoreductase: Potential Urine Biomarker Candidate for Acute Melioidosis

INTRODUCTION: In the current climate of urgency in identifying biomarkers for the development of rapid diagnostic kits, the use of urine samples to diagnose acute melioidosis was evaluated, comparing urine samples from Burkholderia pseudomallei culture-positive and culture-negative patients, and comparing pneumonic and septicemic melioidosis. MATERIAL AND METHODS: Eleven urine samples from clinically suspected melioidosis patients from a tertiary referral center, Hospital Tengku Ampuan Afzan, Pahang was used. An in-solution method for the detection of bacterial proteins using liquid chromatography-mass spectrometry quadrupole time-of-flight (LCMS QTOF) was used. RESULTS: Three bacterial proteins were consistently detected among all the culture[1]positive and PCR-positive cases tested, namely SDR family NAD(P)-dependent oxidoreductase protein (32kDa), 3-hydroxyacyl-CoA dehydrogenase Burkholderia sp. (32kDa), and NAD(P)-dependent dehydrogenase (short-subunit alcohol dehydrogenase family) Burkholderia sp. (33kDa). CONCLUSIONS: Short-chain dehydrogenase (SDO) proteins could potentially be a urine biomarker candidate as these have shown to aid in the ability of Burkholderia spp. to invade host cells as this action is important for the initial intracellular survival of the organism.

Prevalence and correlates of Helicobacter pylori infection among under-five children, adolescent and non-pregnant women in Nepal: Further analysis of Nepal national micronutrient status survey 2016.

Most of the Helicobacter pylori infections occur in developing countries. The risk factors for H. pylori infections are poverty, overcrowding, and unhygienic conditions, which are common problems in under-privileged countries such as Nepal. Despite having a high risk of H. pylori infections, no national level study has been conducted to assess prevalence and correlates of H. pylori infection in Nepal. Therefore, we hypothesized that micronutrients such as iron, vitamin B12 deficiency, socio-economic status, and nutritional status correlate with the prevalence of H. pylori infection in Nepal. We studied prevalence and correlates of H. pylori infection among under-five children, adolescents aged 10-19 years and married non-pregnant women aged 20-49 years using data from the Nepal National Micronutrient Status Survey 2016 (NNMSS-2016). H. pylori infection was examined in stool of 6-59 months old children and 20-49 years old non-pregnant women whereas the rapid diagnostic kit using blood sample was used among adolescent boys and girls. Prevalence of H. pylori infection was 18.2% among 6-59 months old children, 14% among adolescent boys and 16% among adolescent girls aged 10-19 years; and 40% among 20-49 years non-pregnant women. Poor socioeconomic status, crowding, and unhygienic condition were found to be positively associated with higher incidence of H. pylori infections. No significant correlation was observed between nutritional and micronutrients status (iron or risk of folate deficiency) with H. pylori infection. Findings from this study suggest that poverty-associated markers are primary contributors of H. pylori infections in Nepalese communities. To control acquisition and persistence of H. pylori infection in Nepal, we suggest improved management of safe drinking water and implementation of sanitation and hygiene programs, with a focus on those of lower socioeconomic status.

Molecular insight into the genomic variation of SARS-CoV-2 strains from current outbreak

Coronavirus disease 2019 (COVID-19) is the newly emerging viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The epidemic sparked in December 2019 at Wuhan city, China that causes a large global outbreak and a major public health catastrophe. Till now, more than 129 million positive cases have been reported in which more than 2.81 million were dead, surveyed by Johns Hopkins University, USA. The diverse symptoms of COVID-19 and an increased number of positive cases throughout the world hypothesize that this virus assembles more variants that are preventing the pursuit of its adequate treatment as well as the development of the vaccine. In this study, 715 SARS-CoV-2 genomes were retrieved from the gisaid and NCBI viral resources involving 39 countries and 164 different types of variants were identified based on 108 Single Nucleotide Polymorphisms (SNPs) in which the ancestral type of SARS-CoV-2 was found as the most frequent and the most prevalent in China. Moreover, variant type A104 was identified as the most frequent in the USA and A52 in Japan. The study also recognized the most common SNPs such as 241, 3037, 8782, 11083, 14408, 23403, and 28144 as well as variants regarding base-pair, C > T. A total of 65 non-synonymous SNPs were recognized which were mostly located in nucleocapsid phosphoprotein, Non-structural protein 3(Nsp3), and spike glycoprotein encoding gene. Molecular divergence analysis revealed that this virus was phylogenetically related to Yunnan 2013 bat strain. This study indicates SARS-CoV-2 frequently alters their genetic material, which mostly affects the nucleocapsid phosphoprotein, and spike glycoprotein-encoding gene and makes it very challenging to develop SARS-Cov-2 vaccine and antibody-mediated rapid diagnostic kit.

Handheld plasmonic biosensor for virus detection in field-settings

After World Health Organization (WHO) announced COVID-19 outbreak a pandemic, we all again realized the importance of developing rapid diagnostic kits. In this article, we introduced a lightweight and field-portable biosensor employing a plasmonic chip based on nanohole arrays integrated to a lensfree-imaging framework for label-free detection of viruses in field-settings. The platform utilizes a CMOS (complementary metal–oxide–semiconductor) camera with high quantum efficiency in the spectral window of interest to monitor diffraction field patterns of nanohole arrays under the uniform illumination of an LED (light-emitting diode) source which is spectrally tuned to the plasmonic mode supported by the nanohole arrays. As an example for the applicability of our biosensor for virus detection, we could successfully demonstrate the label-free detection of H1N1 viruses, e.g., swine flu, with medically relevant concentrations. We also developed a low-cost and easy-to-use sample preparation kit to prepare the surface of the plasmonic chip for analyte binding, e.g., virus-antibody binding. In order to reveal a complete biosensor technology, we also developed a user friendly Python™ – based graphical user interface (GUI) that allows direct access to biosensor hardware, taking and processing diffraction field images, and provides virus information to the end-user. Employing highly sensitive nanohole arrays and lensfree-imaging framework, our platform could yield an LOD as low as 103 TCID50/mL. Providing accurate and rapid sensing information in a handheld platform, weighing only 70 g and 12 cm tall, without the need for bulky and expensive instrumentation, our biosensor could be a very strong candidate for diagnostic applications in resource-poor settings. As our detection scheme is based on the use of antibodies, it could quickly adapt to the detection of different viral diseases, e.g., COVID-19 or influenza, by simply coating the plasmonic chip surface with an antibody possessing affinity to the virus type of interest. Possessing this ability, our biosensor could be swiftly deployed to the field in need for rapid diagnosis, which may be an important asset to prevent the spread of diseases before turning into a pandemic by isolating patients from the population.

Paradigm Shift in Socio-Demographic Profile of Dengue Infection: A Hospital Based Cross-Sectional Study.

Background:Dengue is the most rapidly spreading mosquito borne viral disease in the world with increasing geographical expansion to new countries and from urban to rural settings due to combination of urbanisation, population growth, increased international travel and trade and global warming. The epidemiology of dengue fever in India has been very complex with a seasonal pattern. The first outbreak in Odisha was in 2010 and is now spreading to different districts of the state.Materials and Methods:A hospital based cross-sectional study was carried out between 2017 to 2018 in the dengue ward of a teaching hospital in Berhampur, Ganjam district of Odisha.Results:The prevalence of admitted dengue patients was 4.32%. Majority of the patients were males (81.9%) and ≥15 years old (91.7%). About 68.5% were from rural areas and belonged to low socio-economic status (53.2%). Cases were reported mostly in peri-monsoon periods and 65.7% of them came directly to the hospital.Conclusion:The study highlights the need to curb the rural spread of the disease through activities in creating awareness among all section of people to promote control measures and early reporting of all fever cases, capacity building of rural doctors for early detection, treatment and early referral of high-risk patients and availability of ELISA based tests in sub-district hospitals along with Rapid Diagnostic Kits (RDKs). Emphasis for preventive and control measures to be increased during peri-monsoon periods and also to be instituted in offices, educational institutes and other indoor activity areas.

Malaria among the Sauria Paharia, a primitive and vulnerable tribe of Jharkhand state, India

BackgroundPakur district of Jharkhand state is highly malaria-endemic areas in eastern India, mainly inhabited by Sauria Paharia, a primitive and vulnerable tribal group. MethodsAn epidemiological, entomological and malaria-related community-based education; and evaluation of the operational strategies for malaria interventions were performed in eight vulnerable forests-fringed tribal villages in the Pakur district of Jharkhand, India. ResultsOf the 217 confirmed malaria infections, P. falciparum (92.2%), P. vivax (7.8%), and mixed-species infections (6.9%) were found. The SPR, SFR and Pf% ranged from 23.8 to 68.2, 23.8–64.8 and 84.2–100.0, respectively. An. culicifacies, An. annularis, An. fluviatilis and An. minimus became the primary vectors of malaria. Insecticidal susceptibility status indicates An. culicifacies and An. annularis resistance to DDT (4%); and An. culicifacies, An. annularis and An. fluviatilis susceptible to malathion (5%) and deltamethrin (0.05%). Most residents, including health staff, had excellent knowledge of malaria but did not adopt appropriate prevention steps. Many accredited social health activist workers have not trained to diagnose and treat malaria cases, nor have rapid diagnostic test kits and antimalarial drugs been available, resulting in the tribal community adopting traditional treatments and native remedies. ConclusionHigh vector abundance, presence of parasite load, deficiency of prevention practices; and lack of early detection and prompt treatment and vector control strategies indicate that the population living in these provinces is more vulnerable to malaria. Therefore, periodic surveillance, monitoring, and evaluation are also needed to enhance the implementation of malaria interventions in this region.

Seroprevalence and Clinical Features of Scrub Typhus among Febrile Patients Attending a Referral Hospital in Kathmandu, Nepal.

(1) Background: Scrub typhus (ST) is endemic to Nepal. It is often underdiagnosed and misdiagnosed due to non-specific clinical presentation coupled with limited microbiological facilities, leading to adverse clinical outcomes. This study aimed to assess the seroprevalence of scrub typhus in febrile patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH), Nepal, from August 2018 to April 2019. (2) Materials and Method: Blood/serum samples and clinical and demographic data of adult febrile patients (≥19 years) who attended or were referred to the hospital were collected after obtaining written informed consent from the participants excluding immunocompromised individuals. Collected blood/serum samples were subjected to hematological, biochemical, and serological tests. A serological test for scrub typhus was performed using the ImmuneMed scrub typhus rapid diagnostic test kit. Data generated were analyzed using SPSS software version 24.0. (3) Results: Amongst the 2070 febrile patients, 462 (22.3%) were seropositive to at least one etiological agent of febrile illnesses (scrub typhus: 253 cases, dengue: 101 cases, leptospirosis: 9, brucellosis: 52, malaria: 9 and kala-azar: 20 cases). Scrub typhus accounted for 12.2% (n = 253) of total febrile illnesses followed by dengue (4.9%, n = 101). Mixed seropositivity of scrub typhus with dengue, brucellosis, and typhoid was found in 12 (0.6%), 9 (0.4%), and 5 (0.2%) cases, respectively. Among 253 scrub typhus patients, 53.4% were female. Among the 154 patients, the most common symptoms were fever (100%), headache (79.2%), sweating (70.1%), breathing difficulty (51.3%), redness of the eye (43.5%), and pathognomonic eschar was observed in 9.1% patients. Fifty percent of scrub typhus patients had low platelet count and >30% of patients had an elevated level of liver enzymes (such as serum glutamic oxaloacetic transaminase (SGPT) and serum glutamic pyruvic transaminase (SGOT). (4) Conclusion: Scrub typhus is a considerable cause of febrile illness in Nepal. Females apparently have a higher chance of acquiring scrub typhus. ST presents nonspecific clinical presentation. The diagnostic dilemma of typhus patients can be minimized by the early monitoring of ST-associated symptoms. The country’s health system needs to be strengthened for early outbreak detection, and immediate response actions against scrub typhus to control the future outbreak of ST.