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PCR-based verification of positive rapid diagnostic tests for intestinal protozoa infections with variable test band intensity
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 3870839
Author(s) Becker, Sören L.; Müller, Ivan; Mertens, Pascal; Herrmann, Mathias; Zondie, Leyli; Beyleveld, Lindsey; Gerber, Markus; du Randt, Rosa; Pühse, Uwe; Walter, Cheryl; Utzinger, Jürg
Author(s) at UniBasel Becker, Sören Leif
Müller, Ivan
Gerber, Markus
Pühse, Uwe
Year 2017
Title PCR-based verification of positive rapid diagnostic tests for intestinal protozoa infections with variable test band intensity
Journal Acta Tropica
Volume 174
Pages / Article-Number 49-55
Mesh terms Animals; Cryptosporidiosis, diagnosis; Diarrhea, parasitology; Feces, parasitology; Giardiasis, epidemiology; Humans; Longitudinal Studies; Multiplex Polymerase Chain Reaction; Polymerase Chain Reaction, methods; Sensitivity and Specificity; South Africa, epidemiology
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.
Publisher Elsevier
ISSN/ISBN 0001-706X ; 1873-6254
Full Text on edoc No
Digital Object Identifier DOI 10.1016/j.actatropica.2017.06.012
PubMed ID
ISI-Number WOS:000408299300008
Document type (ISI) Journal Article

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