True Prevalence Of Infection Research Articles

Estimate of exposure to SARS-CoV-2 and performance of high-risk interventions by European anaesthesiologists: A Pan-European cross-sectional survey.

Estimate of exposure to SARS-CoV-2 and performance of high-risk interventions by European anaesthesiologists: A Pan-European cross-sectional survey.

SARS-CoV-2 PCR positivity rate and seroprevalence of related antibodies among a sample of patients in Cairo: Pre-wave 2 results of a screening program in a university hospital.

Research has revealed that asymptomatic and pre-symptomatic infections are important contributors to the transmission of SARS-CoV-2 in populations. In Egypt, the true prevalence of infections is veiled due to the low number of screening tests. The aim of this study was to determine the SARS-CoV-2 PCR positivity rate as well the seroprevalence of the SARS-CoV-2 antibodies before the ultimate development of a second wave of the epidemic in Cairo, Egypt. Our study was carried out between May 5 and the end of October 2020. It included all patients requiring admission to Ain Shams University hospitals. An interview questionnaire was used to collect demographic and clinical data. Laboratory tests for all participants included RT-PCR and total antibody assay for SARS-CoV-2. A total of 4,313 subjects were enrolled in our study, with females representing 56% of the sample. Adults and middle-aged individuals represented around 60% of the study sample. The positivity rate of SARS-CoV-2 PCR was 3.84% (95% CI 3.29-4.48), and the SARS-CoV-2 antibody seroprevalence was 29.82% (95% CI: 28.16-31.51). Males showed a higher risk for getting the COVID-19 infection, while middle-age group had significantly higher antibody seroprevalence rates. SARS-CoV-2 infection imposes a high burden on the community as detected by high seroprevalence rates.

"Test and Standard Precautions"-Is It Enough to Protect Us From False-Negative Severe Acute Respiratory Syndrome Coronavirus 2 Test Results?

"Test and Standard Precautions"-Is It Enough to Protect Us From False-Negative Severe Acute Respiratory Syndrome Coronavirus 2 Test Results?

Estimating prevalence and test accuracy in disease ecology: How Bayesian latent class analysis can boost or bias imperfect test results.

Obtaining accurate estimates of disease prevalence is crucial for the monitoring and management of wildlife populations but can be difficult if different diagnostic tests yield conflicting results and if the accuracy of each diagnostic test is unknown. Bayesian latent class analysis (BLCA) modeling offers a potential solution, providing estimates of prevalence levels and diagnostic test accuracy under the realistic assumption that no diagnostic test is perfect.In typical applications of this approach, the specificity of one test is fixed at or close to 100%, allowing the model to simultaneously estimate the sensitivity and specificity of all other tests, in addition to infection prevalence. In wildlife systems, a test with near‐perfect specificity is not always available, so we simulated data to investigate how decreasing this fixed specificity value affects the accuracy of model estimates.We used simulations to explore how the trade‐off between diagnostic test specificity and sensitivity impacts prevalence estimates and found that directional biases depend on pathogen prevalence. Both the precision and accuracy of results depend on the sample size, the diagnostic tests used, and the true infection prevalence, so these factors should be considered when applying BLCA to estimate disease prevalence and diagnostic test accuracy in wildlife systems. A wildlife disease case study, focusing on leptospirosis in California sea lions, demonstrated the potential for Bayesian latent class methods to provide reliable estimates under real‐world conditions.We delineate conditions under which BLCA improves upon the results from a single diagnostic across a range of prevalence levels and sample sizes, demonstrating when this method is preferable for disease ecologists working in a wide variety of pathogen systems.

Estimating the prevalence and intensity of Schistosoma mansoni infection among rural communities in Western Tanzania: The influence of sampling strategy and statistical approach.

BackgroundSchistosoma mansoni is a parasite of major public health importance in developing countries, where it causes a neglected tropical disease known as intestinal schistosomiasis. However, the distribution of the parasite within many endemic regions is currently unknown, which hinders effective control. The purpose of this study was to characterize the prevalence and intensity of infection of S. mansoni in a remote area of western Tanzania.Methodology/Principal findingsStool samples were collected from 192 children and 147 adults residing in Gombe National Park and four nearby villages. Children were actively sampled in local schools, and adults were sampled passively by voluntary presentation at the local health clinics. The two datasets were therefore analysed separately. Faecal worm egg count (FWEC) data were analysed using negative binomial and zero-inflated negative binomial (ZINB) models with explanatory variables of site, sex, and age. The ZINB models indicated that a substantial proportion of the observed zero FWEC reflected a failure to detect eggs in truly infected individuals, meaning that the estimated true prevalence was much higher than the apparent prevalence as calculated based on the simple proportion of non-zero FWEC. For the passively sampled data from adults, the data were consistent with close to 100% true prevalence of infection. Both the prevalence and intensity of infection differed significantly between sites, but there were no significant associations with sex or age.Conclusions/SignificanceOverall, our data suggest a more widespread distribution of S. mansoni in this part of Tanzania than was previously thought. The apparent prevalence estimates substantially under-estimated the true prevalence as determined by the ZINB models, and the two types of sampling strategies also resulted in differing conclusions regarding prevalence of infection. We therefore recommend that future surveillance programmes designed to assess risk factors should use active sampling whenever possible, in order to avoid the self-selection bias associated with passive sampling.

Toxoplasma gondii detection in cattle: A slaughterhouse survey

Toxoplasmosis is a zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Ingestion of raw or undercooked meat containing viable cysts has been suggested to be a major source of T. gondii infection in humans. Suboptimal performance of serological assays in cattle has traditionally precluded accurate quantification of the extent to which cattle populations are infected and their meat harbour tissue cysts. In the absence of accurate estimates of the level of infection in the animal population, assessments of likely human exposure through the consumption of cattle meat remain highly speculative. Following the development of novel and sensitive molecular methods that can be applied to the relatively large numbers of samples required in observational studies, the first quantitative estimates of the frequency of T. gondii in meat samples from naturally infected cattle have become available recently. Such estimates are critical for the development of quantitative risk assessment models that could be used to inform food safety policies. The aim of this study was to generate the first estimates of the prevalence of T. gondii infection in a sample of cattle exposed to natural levels of infection and slaughtered for human consumption in the UK under commercial conditions. Such estimates provide great value to the global assessment of T. gondii burden given the scarcity of data available on the frequency of natural infection in cattle populations worldwide.Between October 2015 and January 2016 diaphragm samples were collected from 305 animals, slaughtered in ten commercial slaughterhouses across the UK. Movement histories showed that the animals sampled (41.6% females and 58.4% males) had passed through a total of 614 farms and 40 livestock markets across the country. Five animals (1.6%) were deemed positive for T. gondii following magnetic capture real-time PCR, confirmed by amplicon sequencing. The true prevalence of infection was estimated to be 1.79%. All positive animals were male, none of whom had been on the same farm and/or livestock market before slaughter and there was no apparent geographic pattern. The results from this study suggest a low level of infection in cattle raised and slaughtered in the UK and can be used to populate the first stages of formal risk assessments to quantify the likely extent of human exposure to T. gondii through the consumption of beef with relevance to the UK, EU and rest of the world.

Epidemic 2014 enterovirus D68 cross-reacts with human rhinovirus on a respiratory molecular diagnostic platform.

Enterovirus D68 (EV-D68) is an emerging virus known to cause sporadic disease and occasional epidemics of severe lower respiratory tract infection. However, the true prevalence of infection with EV-D68 is unknown, due in part to the lack of a rapid and specific nucleic acid amplification test as well as the infrequency with which respiratory samples are analyzed by enterovirus surveillance programs. During the 2014 EV-D68 epidemic in the United States, we noted an increased frequency of “low-positive” results for human rhinovirus (HRV) detected in respiratory tract samples using the GenMark Diagnostics eSensor respiratory viral panel, a multiplex PCR assay able to detect 14 known respiratory viruses but not enteroviruses. We simultaneously noted markedly increased admissions to our Pediatric Intensive Care Unit for severe lower respiratory tract infections in patients both with and without a history of reactive airway disease. Accordingly, we hypothesized that these “low-positive” RVP results were due to EV-D68 rather than rhinovirus infection. Sequencing of the picornavirus 5’ untranslated region (5’-UTR) of 49 samples positive for HRV by the GenMark RVP revealed that 33 (67.3%) were in fact EV-D68. Notably, the mean intensity of the HRV RVP result was significantly lower in the sequence-identified EV-D68 samples (20.3 nA) compared to HRV (129.7 nA). Using a cut-off of 40 nA for the differentiation of EV-D68 from HRV resulted in 94% sensitivity and 88% specificity. The robust diagnostic characteristics of our data suggest that the cross-reactivity of EV-D68 and HRV on the GenMark Diagnostics eSensor RVP platform may be an important factor to consider in making accurate molecular diagnosis of EV-D68 at institutions utilizing this system or other molecular respiratory platforms that may also cross-react.

Incidence of Gonorrhea and Chlamydia in Urban Settings: The Case for Neighborhood Level Analysis in Boston

The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demographic factors such as poverty and race/ethnicity may contribute to a difference in treatment setting choice as well as a delay in care seeking. In an urban metropolitan area such as Boston, the overall gonorrhea and chlamydia rates are higher than national rates, and such differences are even more marked in certain neighborhoods with greater proportions of individuals who are impoverished, young, and of color. Using a retrospective analysis of city wide data, we highlight the effects of socioeconomic and demographic variables on urban STI prevalence. High poverty rates, race/ethnicity and younger adult populations are linked to disproportionately high STI rates. Interestingly, STI rates do not appear to be influenced by the universal health care coverage offered to the whole Massachusetts’ resident populations. We examine the effects of these variables in Boston neighborhoods in conjunction to STI rates and hypothesize that the observed rates are underestimates of the true prevalence of infection. Future studies will investigate how these same socioeconomic and demographic factors influence which treatment settings are chosen and subsequently lead to a delay in treatment.

P71 Validation of an in house nucleic acid amplification (NAATs) PCR test for Trichomonas vaginalis

BackgroundTrichomonas vaginalis, a flagellated protozoan, is transmitted through sexual contact that commonly manifests itself as symptomatic in more women than men. However, the true prevalence of infection and the proportion...

Detection of infection with Angiostrongylus vasorum (Nematoda, Strongylida) by PCR

Background The French heart worm Angiostrongylus vasorum is a parasitic nematode of the pulmonary arteries and heart of canines often with severe and in some cases fatal outcome. The diagnosis is based on detection and species identification of larvae in faeces which can be problematic in Veterinary praxis especially in cases with low excreting animals. A reliable technique is thus needed for correct diagnosis and estimation of the true prevalence of infection in a population as well as for monitoring and control campaigns.

Estimated prevalence of Mycobacterium avium subspecies paratuberculosis infection in herds of dairy goats in France

A study of the prevalence of Mycobacterium avium subspecies paratuberculosis (MAP) infection in dairy goats was carried out in France, using a serological ELISA. One hundred and five herds were...

Campylobacter enteritis in the Arabian Gulf

Diarrhoea illnesses constitute a common cause of morbidity and mortality worldwide. In recent years, Campylobacter spp. has been recognized as the leading cause of bacterial enteritis in both developed and developing countries. The biology of Campylobacters as well as the mechanism by which they cause disease is yet to be fully explained. In addition, non-availability of fast and reliable diagnostic methodology and the growing trend of antibiotic resistance continue to pose significant challenges. The absence of national surveillance programs for campylobacteriosis, particularly in developing countries, makes it difficult to give an accurate picture of the true infection prevalence and the molecular epidemiology of isolates circulating in the populations, a situation which had hitherto existed in the Arabian Gulf region. However, in recent years, emerging data from studies in the Arabian Gulf region has not only enhanced our understanding of the epidemiology of Campylobacter both in humans and poultry in the region, but has also contributed to the overall understanding of the mechanism of Campylobacter enteritis, antibiotic resistance, and improved diagnostic approaches. In this review, we examine these emerging data from the Arabian Gulf region.

Detection of schistosomiasis cases in low-transmission areas based on coprologic and serologic criteria: The Venezuelan experience

Low and very-low intensities of infection hinder the diagnosis of schistosomiasis. Therefore, new parameters should be established in order to more accurately identify active cases and true infection prevalence, for the adequate implementation of a control program. After the survey and analysis of the epidemiological characteristics of five Venezuelan communities, we propose three criteria for the definition of a “schistosomiasis case”, based on different diagnostic methods: stool examination, ELISA-soluble egg antigen with sodium metaperiodate (SMP–ELISA), alkaline phosphatase immunoassay (APIA) and the circumoval precipitin test (COPT). Briefly, criterion I: persons with Schistosoma mansoni eggs in stools; criterion II: persons without eggs in stools, with positive COPT, without previous antischistosome chemotherapy in the last year; and criterion III: persons without eggs in stools, with negative COPT, with two positive immunoenzymatic tests (SMP–ELISA and APIA), and with no previous chemotherapy. The incorporation of serological tests to epidemiologic surveillance in areas of low-transmission tries to compensate the underestimation of prevalence based only on parasitological diagnosis.

Neospora caninum seropositivity and association with abortions in dairy cows in Mexico

The seroprevalence of Neospora caninum infection was estimated from a sample of 813 cattle from 20 dairy herds in five regions in Mexico. The true prevalence of infection was estimated to be 42% (95% CI: 39, 46). Seropositivity was associated with abortion (odds ratio (OR) = 2.0) and was higher among cows raised on-farm (41%), than among replacement cattle purchased outside the farm (28%). The ORs relating abortion to seropositivity in individual herds ranged from 1.3 to 10. Overall, 26% of the abortions were attributed to N. caninum.

The emergence of Mycobacterium paratuberculosis in farmed deer in New Zealand — a review of 619 cases

AIM: To review cases in which Mycobacterium paratuberculosis was identified in farmed deer in New Zealand. METHODS: Case histories were reviewed where M. paratuberculosis was identified in deer by either culture or a polymerase chain reaction (PCR) test using primers from IS900. RESULTS: Between 1986 and 2000, M. paratuberculosis was identified by bacterial culture and/or PCR in 619 farmed deer from 299 herds, representing approximately 6% of deer herds in New Zealand. Over 85% of cases were identified during the last 6 years. In 60% of the infected herds, only one infected animal was identified. The maximum number of cases identified in a single deer herd was 47, and these were identified over a period of 8 years. Only 36 (5.8%) cases came from clinically affected animals identified on farms by veterinarians. The majority (89.7%) of the 619 cases were identified from lesions in mesenteric lymph nodes, including the ileocaecal lymph nodes, identified at meat inspection as being macroscopically either typical or equivocal of bovine tuberculosis (M. bovis). While the overwhelming majority of lesions were identified in mesenteric lymph nodes, M. paratuberculosis was also identified in 27 lesions in lymph nodes of the head, especially the retropharyngeal lymph node. CONCLUSIONS: The figures presented underestimate the true prevalence of infection with M. paratuberculosis, especially since not all suspect cases were submitted for culture or PCR. However, they do show that M. paratuberculosis appears to be spreading in farmed deer in New Zealand and highlight the possibility that Johne's disease is emerging as a potential major problem affecting this species. Identification of the organism by bacterial culture or PCR is required in many cases to distinguish lesions in mesenteric lymph nodes and lymph nodes of the head caused by M. paratuberculosis from those caused by M. bovis and M. avium.

A stochastic model to estimate the prevalence of scrapie in Great Britain using the results of an abattoir-based survey

In 1997/1998, an abattoir survey was conducted to determine the likely exposure of the human population to transmissible spongiform encephalopathy (TSE) infection in sheep submitted for slaughter in Great Britain. The survey examined brain material from 2809 sheep processed through British abattoirs. Sampling was targeted by age: 45% of animals tested were ≥15 months old. All samples of adequate quality (98%) were tested for signs of scrapie infection using histopathology and scrapie-associated fibril (SAF) detection and 500 were tested using immunohistochemistry (IHC). No conclusive positive animals were found using either histology or IHC. Ten animals were positive by SAF. Standard statistical analyses suggest (with 95% confidence) that the prevalence of detectable (by histopathology) infection in the slaughter population was ≤0.11%. However, the incubation period of scrapie is long (usually around 2–3 years) and none of the tests used in the survey is capable of detecting scrapie infection in the early stages of infection. We present an age-structured stochastic model incorporating parameters for the incubation period of scrapie, prevalence of infection by age and test sensitivity. Using the model, we demonstrate that the negative results obtained for all samples using IHC and histopathology are consistent with a true prevalence of infection in the slaughter population of up to 11%. This suggests that up to 300 of the animals tested might have been infected but the infection was not sufficiently advanced in these animals to be detectable by IHC or histopathology. The survey was designed to detect a prevalence of 1% with a precision of ±0.5% and a confidence level of 95% in each age group assuming that diagnostic tests were 100% specific and sensitive from a known stage in the incubation period. The results of the model demonstrate that to estimate a true prevalence of scrapie infection of 1% with an accuracy of ±0.5% would have required a far larger sample size. An accurate estimate of the required sample size is complicated by uncertainty about test sensitivity and the underlying infection dynamics of scrapie. A pre-requisite for any future abattoir survey is validation of the diagnostic tests used in relation to both stage of incubation and genotype. Sampling in the <15-month age group was of no value in this survey because the diagnostic tests used were thought to be ineffective in most of the animals in this age group.

Pathogenicity, Serological Responses, and Diagnosis of Experimental and Natural Malarial Infections in Native Hawaiian Thrushes

AbstractOmao (Myadestes obscurus) from the Hawaiian Islands typically have very low prevalences of infection with avian malaria (Plasmodium relictum) and it is not clear whether they share the same high susceptibility to this parasite that has been documented in native Hawaiian honeycreepers. We exposed four captive Omao to single infective mosquito bites and measured parasitemia, serological responses, and mortality over time. All four birds experienced transient infections with low parasitemias and were immune when rechallenged with multiple infective mosquito bites. By contrast, three of four honeycreepers (Maui Alauahio, Paroreomyza montana) that were exposed to the same dose and parasite isolate succumbed to infection. All four Omao developed antibodies to a common suite of malarial antigens that were detectable on immunoblots of a crude red blood cell extract of P. relictum. We used this technique to screen plasma samples from wild Omao and endangered Puaiohi (Myadestes palmeri) that were captured at elevations between 900 and 1300 m on the islands of Hawaii and Kauai. We found that the true prevalence of infection at elevations where active malaria transmission occurs is much higher than estimates based on blood smears alone. Hawaiian thrushes appear to have a high tolerance for malaria, with most individuals developing chronic, low-level infections after exposure that cannot be diagnosed accurately by blood smears.

PATHOGENICITY, SEROLOGICAL RESPONSES, AND DIAGNOSIS OF EXPERIMENTAL AND NATURAL MALARIAL INFECTIONS IN NATIVE HAWAIIAN THRUSHES1

Omao (Myadestes obscurus) from the Hawaiian Islands typically have very low prevalences of infection with avian malaria (Plasmodium relictum) and it is not clear whether they share the same high susceptibility to this parasite that has been documented in native Hawaiian honeycreepers. We exposed four captive Omao to single infective mosquito bites and measured parasitemia, serological responses, and mortality over time. All four birds experienced transient infections with low parasitemias and were immune when rechallenged with multiple infective mosquito bites. By contrast, three of four honeycreepers (Maui Alauahio, Paroreomyza montana) that were exposed to the same dose and parasite isolate succumbed to infection. All four Omao developed antibodies to a common suite of malarial antigens that were detectable on immunoblots of a crude red blood cell extract of P. relictum. We used this technique to screen plasma samples from wild Omao and endangered Puaiohi (Myadestes palmeri) that were captured at elevations between 900 and 1300 m on the islands of Hawaii and Kauai. We found that the true prevalence of infection at elevations where active malaria transmission occurs is much higher than estimates based on blood smears alone. Hawaiian thrushes appear to have a high tolerance for malaria, with most individuals developing chronic, low-level infections after exposure that cannot be diagnosed accurately by blood smears.

Seroprevalence of Neospora caninum and abortion in dairy cows in northern Spain

The seroprevalence of Neospora caninum infection was estimated from a sample of 889 cattle from 43 dairy herds in three counties in the Asturias region of Spain. The true prevalence...

A laboratory model of canine leishmaniasis: the inoculation of dogs with Leishmania infantum promastigotes from midguts of experimentally infected phlebotomine sandflies.

Twenty-five dogs (beagles) were infected with Leishmania infantum by the intradermal inoculation of an estimated 5-8,000 metacyclic promastigotes harvested from the midguts of 320 experimentally infected P. perniciosus. Details are given of the methods of infecting the flies and harvesting the parasites. All dogs developed small, self-healing chancres at the sites of inoculation. Parasites were isolated from lymph nodes, bone marrow or spleen of 21 dogs, 12 of which developed signs of disease and raised IFAT litres to Leishmania. Nine of the 21 remained healthy over a five-year observation period. Six of the nine were shown to have a cell mediated immune response to Leishmania. No parasites were isolated from four of the 25 dogs, two of which had a demonstrable cell mediated immunity and another had low transitory IFAT titres. The fourth had chancres at the sites of inoculation. The results show that dogs can be readily infected with promastigotes from the midguts of sandflies. However, a high proportion develop a cell mediated immunity and show on signs of disease. It is suggested that serological surveys of dogs for canine leishmaniasis reveal neither the true prevalence of infection nor the intensity of transmission. The efficacy of controlling human visceral leishmaniasis caused by L. infantum by destroying seropositive dogs is questioned.