دورية أكاديمية
أعرض في EDS

A comparative evaluation of three methods for the rapid diagnosis of cryptococcal meningitis (CM) among HIV-infected patients in Northern Malawi.

التفاصيل البيبلوغرافية
العنوان: A comparative evaluation of three methods for the rapid diagnosis of cryptococcal meningitis (CM) among HIV-infected patients in Northern Malawi.
المؤلفون: Chisale MR; Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi.; Luke International, Mzuzu, Malawi.; Department of Biomedical Sciences, Mzuzu University, Mzuzu, Malawi., Salema D; Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi.; University of Malawi, College of Medicine, Blantyre, Malawi., Sinyiza F; Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi., Mkwaila J; Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi., Kamudumuli P; Malawi Lab Project, University Research Co., LLC, Lilongwe, Malawi., Lee HY; Luke International, Mzuzu, Malawi.; Department of Biomedical Sciences, Mzuzu University, Mzuzu, Malawi.; Pingtung Christian Hospital, Pingtung, Taiwan.
المصدر: Malawi medical journal : the journal of Medical Association of Malawi [Malawi Med J] 2020 Mar; Vol. 32 (1), pp. 3-7.
نوع المنشور: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Published by Montfort Press for the Medical Association of Malawi Country of Publication: Malawi NLM ID: 9500170 Publication Model: Print Cited Medium: Internet ISSN: 1995-7270 (Electronic) Linking ISSN: 19957262 NLM ISO Abbreviation: Malawi Med J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Lilongwe, Malawi : Published by Montfort Press for the Medical Association of Malawi, [1990-
مواضيع طبية MeSH: AIDS-Related Opportunistic Infections/*epidemiology , Antifungal Agents/*therapeutic use , Antigens, Fungal/*blood , Cryptococcus/*isolation & purification , HIV Infections/*complications , Meningitis, Cryptococcal/*diagnosis, AIDS-Related Opportunistic Infections/blood ; AIDS-Related Opportunistic Infections/diagnosis ; Adult ; Anti-HIV Agents/therapeutic use ; CD4 Lymphocyte Count ; Cross-Sectional Studies ; Cryptococcus/immunology ; Female ; HIV Infections/drug therapy ; Humans ; Malawi/epidemiology ; Male ; Meningitis, Cryptococcal/blood ; Meningitis, Cryptococcal/drug therapy ; Point-of-Care Systems ; Prospective Studies ; Sensitivity and Specificity
مستخلص: Introduction: Cryptococcal meningitis (CM) is the most common systemic fungal infection in patients with HIV infection. Rapid diagnosis and timely initiation of antifungal therapy are key to reducing mortality rate associated with CM. This study aims to evaluate the ability of four different diagnostic tests (Gram stain, India ink, and two types of commercial lateral flow assay [LFA]) to identify CM-positive patients and to compare the sensitivity and specificity of these tests.
Methods: This was a prospective cross-sectional study on diagnostic tests accuracy conducted in Northern Malawi. The target population was HIV-infected adult patients presenting with features of meningitis. Four types of diagnostic tests were conducted: India ink, Gram stain, and two types of commercial lateral flow assay (LFA) (Immy, Inc., OK, USA and Dynamiker Biotechnology (Tianjin) Co., Ltd), Singapore). Culture was conducted as the reference standard.
Results: A total of 265 samples were collected. The rate of positive CM detection ranged from 6.4% (using India ink) to 14.3% (using LFA). India ink exhibited the lowest sensitivity of 54.8% (95% confidence interval [CI]: 36.0%-72.7%), followed by Gram stain (61.3%; 95% CI: 42.2%-78.2%). The Dynamiker LFA exhibited the highest sensitivity of 100.0% (95% CI: 90.0%-100.0%) but a lower specificity (97.0%; 93.9%-98.8%) compared to the Immy LFA (98.3%; 95% CI: 95.7%-99.5%).
Conclusion: LFA diagnostic methods have the potential to double the detection rate of CM-positive patients in resource-limited countries such as Malawi. As such, LFAs should be considered to become the main diagnostic tests used for CM diagnostics in these countries. Our data indicate that LFAs may be the best method for diagnosing CM and exhibits the highest diagnostic accuracy as it has shown that it outperforms cell culture, the current gold standard.
(© 2020 The College of Medicine and the Medical Association of Malawi.)
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فهرسة مساهمة: Keywords: Diagnostic methods; comparison; cryptococcal meningitis; evaluation; fungal infection
المشرفين على المادة: 0 (Anti-HIV Agents)
0 (Antifungal Agents)
0 (Antigens, Fungal)
تواريخ الأحداث: Date Created: 20200801 Date Completed: 20200825 Latest Revision: 20200825
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7366160
DOI: 10.4314/mmj.v32i1.2
PMID: 32733652
قاعدة البيانات: MEDLINE
الوصف
تدمد:1995-7270
DOI:10.4314/mmj.v32i1.2