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Fulltext Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices

Ballif M, Renner L, Claude Dusingize J, Leroy V, Ayaya S, Wools-Kaloustian K, et al.

J Pediatric Infect Dis Soc, 2015 Mar;4(1):30-8.
PMID: 26407355 DOI: 10.1093/jpids/piu020

BACKGROUND: The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge.
METHODS: We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study.
RESULTS: Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children.
CONCLUSIONS: Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected children.

Matched MeSH terms: Microscopy/methods
Fulltext Comparison between Quantitative Buffy Coat (QBC) and Giemsa-stained Thin Film (GTF) technique for blood protozoan infections in wild rats

Sahimin N, Alias SN, Woh PY, Edah MA, Mohd Zain SN

Trop Biomed, 2014 Sep;31(3):422-31.
PMID: 25382468 MyJurnal

The quantitative buffy coat (QBC) technique and conventional Giemsa thin blood smear was compared to determine the sensitivity and specificity of the technique in detecting blood parasitic infection of the rodent populations from four urban cities in Peninsular Malaysia. A total of 432 blood samples from four rat species (Rattus norvegicus, Rattus rattus diardii, Rattus exulans and Rattus argentiventer) were screened using both techniques and successfully detected two blood protozoan species (Trypanosoma lewisi and Plasmodium sp.) with Trypanosoma lewisi predominantly infecting the population. Results showed that Giemsa-stained thin film (GTF) was the better detection method on blood parasitemia (46.7%) compared to Quantitative Buffy Coat method (38.9%) with overall detection technique sensitivity and specificity at 83.2% and 74.8% respectively. The sensitivity in detection of Trypanosoma lewisi was 84.4% with value slightly lower for Plasmodium sp. infections at 76.6%. Statistical analysis proved that GTF technique was significantly more sensitive in the detection of blood protozoan infections in the rodent population compared to QBC (p<0.05).

Matched MeSH terms: Microscopy/methods*
Fulltext Diagnostic tools in childhood malaria

Amir A, Cheong FW, De Silva JR, Lau YL

Parasit Vectors, 2018 01 23;11(1):53.
PMID: 29361963 DOI: 10.1186/s13071-018-2617-y

Every year, millions of people are burdened with malaria. An estimated 429,000 casualties were reported in 2015, with the majority made up of children under five years old. Early and accurate diagnosis of malaria is of paramount importance to ensure appropriate administration of treatment. This minimizes the risk of parasite resistance development, reduces drug wastage and unnecessary adverse reaction to antimalarial drugs. Malaria diagnostic tools have expanded beyond the conventional microscopic examination of Giemsa-stained blood films. Contemporary and innovative techniques have emerged, mainly the rapid diagnostic tests (RDT) and other molecular diagnostic methods such as PCR, qPCR and loop-mediated isothermal amplification (LAMP). Even microscopic diagnosis has gone through a paradigm shift with the development of new techniques such as the quantitative buffy coat (QBC) method and the Partec rapid malaria test. This review explores the different diagnostic tools available for childhood malaria, each with their characteristic strengths and limitations. These tools play an important role in making an accurate malaria diagnosis to ensure that the use of anti-malaria are rationalized and that presumptive diagnosis would only be a thing of the past.

Matched MeSH terms: Microscopy/methods
Fulltext Light microscopy and molecular identification of Sarcocystis spp. in meat producing animals in Selangor, Malaysia

Latif B, Kannan Kutty M, Muslim A, Hussaini J, Omar E, Heo CC, et al.

Trop Biomed, 2015 Sep;32(3):444-52.
PMID: 26695204 MyJurnal

One thousand and forty-five tissue samples of skeletal muscles, tongue, heart, diaphragm and esophagus were collected from 209 animals (43 sheep, 89 goats and 77 cattle) from an abattoir in Selangor between February and October, 2013. Each sample was divided into three pieces with each piece measuring 2-3 mm3. Each piece was then squeezed between two glass slides and examined microscopically at x 10 magnification for the presence of sarcocystosis. Three positive samples from each animal species were then fixed in 10% formalin for histological processing. Seven positive samples collected from each animal species were preserved at -80°C or 90% ethanol for gene expression studies. Microsarcocysts were detected in 114 (54.5%) animals by light microscopy (LM). The infection rates in sheep, goat and cattle were 86, 61.8 and 28.6% respectively. The highest rate of infection was in the skeletal muscles of sheep (64.9%) and goats (63.6%) and in the heart of cattle (63.6%). The cysts were spindle to oval in shape and two stages were recognized, the peripheral metrocytes and centrally located banana-shaped bradyzoites. 18S rRNA gene expression studies confirmed the isolates from the sheep as S. ovicanis, goats as S. capracanis and cattle as S. bovicanis. This, to the best of our knowledge, is the first molecular identification of an isolate of S. ovicanis and S. capracanis in Malaysia. Further studies with electron microscopy (EM) are required in the future to compare the features of different types of Sarcocysts spp.

Matched MeSH terms: Microscopy/methods*