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Molina-de la Fuente I, Tahita MC, Bérenger K, Ta Tang TH, García L, González V, Benito A, Hübschen JM, Tinto H, Berzosa P. Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso. Pathog Glob Health 2024:1-11. [PMID: 39140699 DOI: 10.1080/20477724.2024.2388489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso.
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Affiliation(s)
- Irene Molina-de la Fuente
- Department of Biomedicine and Biotechnology, School of Pharmacy, University of Alcalá, Madrid, Spain
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
| | - Marc Christian Tahita
- Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
- Institut de Recherche en Sciences de la Sante/Direction Régionale du Centre-Ouest, Bobo Dioulasso, Burkina Faso
| | - Kabore Bérenger
- Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
- Institut de Recherche en Sciences de la Sante/Direction Régionale du Centre-Ouest, Bobo Dioulasso, Burkina Faso
| | - Thuy Huong Ta Tang
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
| | - Luz García
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
| | - Vicenta González
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
| | - Agustín Benito
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
| | - Judith M Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
- Institut de Recherche en Sciences de la Sante/Direction Régionale du Centre-Ouest, Bobo Dioulasso, Burkina Faso
| | - Pedro Berzosa
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- CIBERINFEC - CIBER Infectious Diseases (ISCIII), Madrid, Spain
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2
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M'Bondoukwé NP, Owono-Medang M, Moussavou-Boussougou MN, Akoue Y, Migueba V, Bulaev D, Neven A, James LAJ, Ntsame Ella SA, Mawili-Mboumba DP, Atsame J, Vaillant M, Bouyou Akotet MK. Low diagnostic performance of thick blood smears of 50 µl in comparison with direct examination of 10 µl blood and the leukoconcentration technique of 5ml blood among loiasis-suspected patients with low microfilaremia in Gabon, Central Africa, using the STARD-BLCM guidelines. Parasit Vectors 2024; 17:138. [PMID: 38491557 PMCID: PMC10943916 DOI: 10.1186/s13071-023-06089-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/08/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The aim of this study was to determine performance indicators of thick blood smears of 50 µl (TBS-50), following the Standards for the Reporting of Diagnostic Accuracy Studies-Bayesian Latent Class Model (STARD-BLCM) guidelines. TBS-50 was compared with two common parasitological techniques-direct examination of 10 µl blood and a leukoconcentration of 5 ml-for the diagnosis of microfilaremic loiasis. METHODS The study population was recruited among patients of the Department of Parasitology-Mycology-Tropical Medicine over a period of 1 year. Age, sex, symptoms, and eosinophilia variables were recorded from laboratory registers and medical files. Direct examination of 10 µl of blood, TBS-50, and the leukoconcentration technique with 5 ml of blood were performed for each patient. The classical formula and BLCM were used to determine the diagnostic accuracy of the three techniques as well as the prevalence of microfilaremic loiasis. Three models were built within the framework of BLCM-the BLCM model I and alternative models II and III-for sensitivity analysis. RESULTS In total, 191 patients consented to be included. The direct blood examination and TBS-50 yielded comparable qualitative and quantitative results. Hence, they are reported together. The prevalence of Loa loa microfilaremia was 9.4% (95% CI 5.7-14.5; n = 18/191) with direct blood examination/TBS-50 and 12.6% [8.2-18.1] (n = 24/191) for leukoconcentration. Comparing TBS-50 with the leukoconcentration method using the classical formula, the sensitivity was 75.0% [53.3-90.2], specificity was 100.0% [97.8-100.0], the positive predictive value was 100.0% [81.5-100.0], and the negative predictive value was 96.5% [92.6-98.7]. The prevalence of microfilaremic loiasis was estimated at 9.7% [6.2-13.7] using BLCM model I. The outputs of BLCM model I showed sensitivity of 78.9% [65.3-90.3], specificity of 100.0% [99.3-100.0], a positive predictive value of 99.1% [87.2-100.0], and a negative predictive value of 93.0% [87.3-97.7] for direct blood examination/TBS-50. CONCLUSIONS TBS-50 demonstrates low sensitivity relative to two other techniques. In one in five cases, the result will be falsely declared negative using these methods. However, this method can be deployed with limited funds.
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Affiliation(s)
- Noé Patrick M'Bondoukwé
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon.
| | - Matthieu Owono-Medang
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Marie Noëlle Moussavou-Boussougou
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Yvan Akoue
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Valentin Migueba
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Dmitry Bulaev
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Anouk Neven
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Luice Aurtin Joel James
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | | | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Julienne Atsame
- Programme de Lutte Contre les Maladies Parasitaires, Ministère de la Santé du Gabon, Libreville, Gabon
| | - Michel Vaillant
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Marielle Karine Bouyou Akotet
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
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Oyeyemi OT, Ogundahunsi O, Schunk M, Fatem RG, Shollenberger LM. Neglected tropical disease (NTD) diagnostics: current development and operations to advance control. Pathog Glob Health 2024; 118:1-24. [PMID: 37872790 PMCID: PMC10769148 DOI: 10.1080/20477724.2023.2272095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Neglected tropical diseases (NTDs) have become important public health threats that require multi-faceted control interventions. As late treatment and management of NTDs contribute significantly to the associated burdens, early diagnosis becomes an important component for surveillance and planning effective interventions. This review identifies common NTDs and highlights the progress in the development of diagnostics for these NTDs. Leveraging existing technologies to improve NTD diagnosis and improving current operational approaches for deployment of developed diagnostics are crucial to achieving the 2030 NTD elimination target. Point-of-care NTD (POC-NTD) diagnostic tools are recommended preferred diagnostic options in resource-constrained areas for mapping risk zones and monitoring treatment efficacy. However, few are currently available commercially. Technical training of remote health care workers on the use of POC-NTD diagnostics, and training of health workers on the psychosocial consequences of these diagnostics are critical in harnessing POC-NTD diagnostic potential. While the COVID-19 pandemic has challenged the possibility of achieving NTD elimination in 2030 due to the disruption of healthcare services and dwindling financial support for NTDs, the possible contribution of NTDs in exacerbating COVID-19 pandemic should motivate NTD health system strengthening.
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Affiliation(s)
- Oyetunde T. Oyeyemi
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Nigeria
- Department of Biological Sciences, Old Dominion University, Virginia, USA
| | - Olumide Ogundahunsi
- The Central Office for Research and Development (CORD), University of Medical Sciences, Ondo, Nigeria
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU) institution, Munich, Germany
| | - Ramzy G. Fatem
- Schistosome Biological Supply Center, Theodor Bilharz Research Institute, Giza, Egypt
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Dahmer KJ, Palma-Cuero M, Ciuoderis K, Patiño C, Roitman S, Li Z, Sinha A, Hite JL, Cuellar OB, Hernandez-Ortiz JP, Osorio JE, Christensen BM, Carlow CKS, Zamanian M. Molecular Surveillance Detects High Prevalence of the Neglected Parasite Mansonella ozzardi in the Colombian Amazon. J Infect Dis 2023; 228:1441-1451. [PMID: 37566913 PMCID: PMC10640775 DOI: 10.1093/infdis/jiad331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Mansonellosis is an undermapped insect-transmitted disease caused by filarial nematodes that are estimated to infect hundreds of millions of people. Despite their prevalence, there are many outstanding questions regarding the general biology and health impacts of the responsible parasites. Historical reports suggest that the Colombian Amazon is endemic for mansonellosis and may serve as an ideal location to pursue these questions. METHODS We deployed molecular and classical approaches to survey Mansonella prevalence among adults belonging to indigenous communities along the Amazon River and its tributaries near Leticia, Colombia. RESULTS Loop-mediated isothermal amplification (LAMP) assays on whole-blood samples detected a much higher prevalence of Mansonella ozzardi infection (approximately 40%) compared to blood smear microscopy or LAMP performed using plasma, likely reflecting greater sensitivity and the ability to detect low microfilaremias and occult infections. Mansonella infection rates increased with age and were higher among men. Genomic analysis confirmed the presence of M. ozzardi that clusters closely with strains sequenced in neighboring countries. We successfully cryopreserved M. ozzardi microfilariae, advancing the prospects of rearing infective larvae in controlled settings. CONCLUSION These data suggest an underestimation of true mansonellosis prevalence, and we expect that these methods will help facilitate the study of mansonellosis in endemic and laboratory settings.
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Affiliation(s)
- Kendra J Dahmer
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Monica Palma-Cuero
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Karl Ciuoderis
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Universidad Nacional de Colombia–University of Wisconsin-Global Health Institute, Medellín, Colombia
| | - Claudia Patiño
- One Health Colombia, Universidad Nacional de Colombia–University of Wisconsin-Global Health Institute, Medellín, Colombia
| | | | - Zhiru Li
- New England Biolabs, Ipswich, Massachusetts, USA
| | - Amit Sinha
- New England Biolabs, Ipswich, Massachusetts, USA
| | - Jessica L Hite
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Juan P Hernandez-Ortiz
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Universidad Nacional de Colombia–University of Wisconsin-Global Health Institute, Medellín, Colombia
| | - Jorge E Osorio
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Bruce M Christensen
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Mostafa Zamanian
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- One Health Colombia, Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Ta-Tang TH, Febrer-Sendra B, Berzosa P, Rubio JM, Romay-Barja M, Ncogo P, Agudo D, Herrador Z, Fernández-Soto P, Muro A, Benito A. Comparison of three PCR-based methods to detect Loa loa and Mansonella perstans in long-term frozen storage dried blood spots. Trop Med Int Health 2022; 27:686-695. [PMID: 35653502 DOI: 10.1111/tmi.13786] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Loa loa and Mansonella perstans are two very common filarial species in Africa. Although microscopy is the traditional diagnostic method for human filariasis, several polymerase chain reaction (PCR) methods have emerged as an alternative approach for identifying filarial parasites. The aim of this study is to compare three molecular methods and decide which is the most suitable for diagnosing human loiasis and mansonellosis in non-endemic regions using dried blood spot (DBS) as a medium for sample collection and storage. METHODS A total of 100 DBS samples, with their corresponding thin and thick blood smears, were selected for this study. Microscopy was used as the reference method to diagnose and calculate the microfilaraemia. Filarial DNA was extracted using the saponin/Chelex method and the DNA isolated was assayed by Filaria-real time-PCR, filaria-nested PCR, and cytochrome oxidase I PCR. All PCR products were subsequently purified and sequenced. The statistical values for each molecular test were calculated and compared. RESULTS Overall, 64 samples were identified as negative by all tests and a further 36 samples were positive by at least one of the methods used. The sensitivity and specificity were similar for the different molecular methods, all of which demonstrated good agreement with microscopy. CONCLUSIONS Based on this study, and from a practical point of view (single and short amplification round), the optimal technique for diagnosing filarial infection in non-endemic regions is filaria-real time-PCR, which presents high sensitivity and specificity and is also able to detect a wide range of human filariae.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Biomedical Research Networking Center of Infectious Diseases, Madrid, Spain.,Cooperative Research Network in Tropical Diseases, Madrid, Spain
| | - Begoña Febrer-Sendra
- Cooperative Research Network in Tropical Diseases, Madrid, Spain.,Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Pedro Berzosa
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Biomedical Research Networking Center of Infectious Diseases, Madrid, Spain.,Cooperative Research Network in Tropical Diseases, Madrid, Spain
| | - José Miguel Rubio
- Cooperative Research Network in Tropical Diseases, Madrid, Spain.,Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Center, Institute of Health Carlos III, Madrid, Spain
| | - María Romay-Barja
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Biomedical Research Networking Center of Infectious Diseases, Madrid, Spain.,Cooperative Research Network in Tropical Diseases, Madrid, Spain
| | - Policarpo Ncogo
- Ministry of Health, Malabo, Equatorial Guinea.,Fundación Estatal, Salud, Infancia y Bienestar Social, Madrid, Spain
| | - Diego Agudo
- Facultad de Ciencias Biológicas, Universidad Complutense de Madrid, Madrid, Spain
| | - Zaida Herrador
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Biomedical Research Networking Center of Infectious Diseases, Madrid, Spain.,Cooperative Research Network in Tropical Diseases, Madrid, Spain
| | - Pedro Fernández-Soto
- Cooperative Research Network in Tropical Diseases, Madrid, Spain.,Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Antonio Muro
- Cooperative Research Network in Tropical Diseases, Madrid, Spain.,Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Agustín Benito
- Malaria and Neglected Tropical Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Biomedical Research Networking Center of Infectious Diseases, Madrid, Spain.,Cooperative Research Network in Tropical Diseases, Madrid, Spain
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