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

Becker, Sören L. and Müller, Ivan and Mertens, Pascal and Herrmann, Mathias and Zondie, Leyli and Beyleveld, Lindsey and Gerber, Markus and du Randt, Rosa and Pühse, Uwe and Walter, Cheryl and Utzinger, Jürg. (2017) PCR-based verification of positive rapid diagnostic tests for intestinal protozoa infections with variable test band intensity. Acta Tropica, 174. pp. 49-55.

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Official URL: http://edoc.unibas.ch/55636/

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Abstract

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.
Faculties and Departments:03 Faculty of Medicine > Departement Sport, Bewegung und Gesundheit > Bereich Sportwissenschaft > Sport und psychosoziale Gesundheit (Gerber)
03 Faculty of Medicine > Departement Sport, Bewegung und Gesundheit > Bereich Sportwissenschaft > Sportwissenschaften (Pühse)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Becker, Sören Leif and Müller, Iwan Martin and Gerber, Markus and Pühse, Uwe
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0001-706X
e-ISSN:1873-6254
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:18 Feb 2019 10:22
Deposited On:20 Oct 2017 06:57

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