PCR-based verification of positive rapid diagnostic tests for intestinal protozoa infections with variable test band intensity

Copyright © 2017 Elsevier B.V. All rights reserved..

Stool-based rapid diagnostic tests (RDTs) for pathogenic intestinal protozoa (e.g. Cryptosporidium spp. and Giardia intestinalis) allow for prompt diagnosis and treatment in resource-constrained settings. Such RDTs can improve individual patient management and facilitate population-based screening programmes in areas without microbiological laboratories for confirmatory testing. However, RDTs are difficult to interpret in case of 'trace' results with faint test band intensities and little is known about whether such ambiguous results might indicate 'true' infections. In a longitudinal study conducted in poor neighbourhoods of Port Elizabeth, South Africa, a total of 1428 stool samples from two cohorts of schoolchildren were examined on the spot for Cryptosporidium spp. and G. intestinalis using an RDT (Crypto/Giardia DuoStrip; Coris BioConcept). Overall, 121 samples were positive for G. intestinalis and the RDT suggested presence of cryptosporidiosis in 22 samples. After a storage period of 9-10 months in cohort 1 and 2-3 months in cohort 2, samples were subjected to multiplex PCR (BD Max™ Enteric Parasite Panel, Becton Dickinson). Ninety-three percent (112/121) of RDT-positive samples for G. intestinalis were confirmed by PCR, with a correlation between RDT test band intensity and quantitative pathogen load present in the sample. For Cryptosporidium spp., all positive RDTs had faintly visible lines and these were negative on PCR. The performance of the BD Max™ PCR was nearly identical in both cohorts, despite the prolonged storage at disrupted cold chain conditions in cohort 1. The Crypto/Giardia DuoStrip warrants further validation in communities with a high incidence of diarrhoea.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:174

Enthalten in:

Acta tropica - 174(2017) vom: 07. Okt., Seite 49-55

Sprache:

Englisch

Beteiligte Personen:

Becker, Sören L [VerfasserIn]
Müller, Ivan [VerfasserIn]
Mertens, Pascal [VerfasserIn]
Herrmann, Mathias [VerfasserIn]
Zondie, Leyli [VerfasserIn]
Beyleveld, Lindsey [VerfasserIn]
Gerber, Markus [VerfasserIn]
du Randt, Rosa [VerfasserIn]
Pühse, Uwe [VerfasserIn]
Walter, Cheryl [VerfasserIn]
Utzinger, Jürg [VerfasserIn]

Links:

Volltext

Themen:

Cryptosporidium spp.
Giardia intestinalis
Intestinal protozoa
Journal Article
Multiplex PCR
Rapid diagnostic test
South Africa

Anmerkungen:

Date Completed 20.02.2018

Date Revised 02.12.2018

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.actatropica.2017.06.012

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM273123408