Evaluation of rK39 rapid diagnostic tests for canine visceral leishmaniasis : longitudinal study and meta-analysis

Canine visceral leishmaniasis is a vector-borne disease caused by the intracellular parasite Leishmania infantum. It is an important veterinary disease, and dogs are also the main animal reservoir for human infection. The disease is widespread in the Mediterranean area, and parts of Asia and South and Central America, and is potentially fatal in both dogs and humans unless treated. Diagnosis of canine infections requires serological or molecular tests. Detection of infection in dogs is important prior to treatment, and in epidemiological studies and control programmes, and a sensitive and specific rapid diagnostic test would be very useful. Rapid diagnostic tests (RDTs) have been developed, but their diagnostic performance has been reported to be variable. We evaluated the sensitivity of a RDT based on serological detection of the rK39 antigen in a cohort of naturally infected Brazilian dogs. The sensitivity of the test to detect infection was relatively low, but increased with time since infection and the severity of infection. We then carried out a meta-analysis of published studies of rK39 RDTs, evaluating the sensitivity to detect disease and infection. The results suggest that rK39 RDTs may be useful in a veterinary clinical setting, but the sensitivity to detect infection is too low for operational control programmes

Effect of Brucella Infection on Reproduction Conditions of Female Breeding Cattle and Its Public Health Significance in Western Tigray, Northern Ethiopia

The most common clinical manifestations of brucellosis in livestock are associated with reproduction. This paper reports the result of a cross-sectional study conducted between October, 2007 and April, 2008 in Western Tigray, North Ethiopia, with the objectives of assessing the effect of Brucella infection on reproduction conditions of female breeding bovine and to explore the presence of Brucella seroreactors in vulnerable humans. A total of 1,354 and 246 sera were collected from female cattle and humans, respectively. The sera were screened using Rose Bengal plate test (RBPT), and positive samples were confirmed by complement fixation test (CFT). Reproductive conditions for female cattle and risk to human brucellosis seropositivity were tested by using logistic regression analysis. The result indicated that the overall prevalence in female cattle was 6.1%. The study showed 1.2% prevalence among human risk groups, all of which were herdsmen. Logistic regression identified parity status, calving interval, abortion history, and abortion period were significantly associated with seropositivity. The association was not significant with reproductive status and parity number. Proper hygienic practices and team work between veterinary and health personnel should improve the efforts to combat disease transmission

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model

Background: Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality service by improving data handling and communication in healthcare setting. EMR implementation in developing countries is increasing exponentially. But, only few of them are successfully implemented. Intention to use EMRs by health care provider is crucial for successful implementation and adoption of EMRs. However, intention of health care providers to use EMR in Ethiopia is unknown. Objective: The aim of this study was to assess health care provider’s intention to use and its predictors towards Electronic Medical Record systems at three referral hospitals in north-west, Ethiopia, 2019. Methods: Institutional based cross-sectional explanatory study design was conducted from March to September among 420 health care providers working at three referral hospitals in north-west Ethiopia. Data were analyzed using structural equation model (SEM). Simple and multiple SEM were used to assess the determinants of health care providers intention to use EMRs. Critical ratio and standardized coefficients were used to measure the association of dependent and independent variables, 95% confidence intervals and P-value were calculated to evaluate statistical significance. Qualitative data was analyzed using thematic analysis. Result: The mean age of the study subjects was 32.4 years ±8.3 SD. More than two-third 293(69.8%) of the participants were male. Among 420 health care providers, only 167 (39.8%) were scored above the mean of intention to use EMRs. Factors positively associated with intention to use EMRs were performance expectancy (β = 0.39, p < 0.001), effort expectancy (β = 0.24,p < 0.001),social influence (β = 0.18,p < 0.001),facilitating condition (β = 0.23,p < 0.001), and computer literacy (β = 0.08,p < 0.001). Performance expectancy was highly associated with intention to use EMRs. Conclusion: Generally, about 40 % of health care providers were scored above the mean of intention to use EMRs. Performance expectancy played a major role in determining health care providers’ intention to use EMRs. The intention of health care providers to use EMRs was attributed by social influence, facilitating condition in the organization, effort expectancy, performance expectancy and computer literacy. Therefore, identifying necessary prerequisites before the actual implementation of EMRs will help to improve the implementation status.publishedVersio

An overview of the clinical use of filter paper in the diagnosis of tropical diseases.

Tropical infectious diseases diagnosis and surveillance are often hampered by difficulties of sample collection and transportation. Filter paper potentially provides a useful medium to help overcome such problems. We reviewed the literature on the use of filter paper, focusing on the evaluation of nucleic acid and serological assays for diagnosis of infectious diseases using dried blood spots (DBS) compared with recognized gold standards. We reviewed 296 eligible studies and included 101 studies evaluating DBS and 192 studies on other aspects of filter paper use. We also discuss the use of filter paper with other body fluids and for tropical veterinary medicine. In general, DBS perform with sensitivities and specificities similar or only slightly inferior to gold standard sample types. However, important problems were revealed with the uncritical use of DBS, inappropriate statistical analysis, and lack of standardized methodology. DBS have great potential to empower healthcare workers by making laboratory-based diagnostic tests more readily accessible, but additional and more rigorous research is needed

Tsetse bloodmeal analyses incriminate the common warthog Phacochoerus africanus as an important cryptic host of animal trypanosomes in smallholder cattle farming communities in Shimba Hills, Kenya

Trypanosomes are endemic and retard cattle health in Shimba Hills, Kenya. Wildlife in the area act as reservoirs of the parasites. However, wild animal species that harbor and expose cattle to tsetse-borne trypanosomes are not well known in Shimba Hills. Using xeno-monitoring surveillance to investigate wild animal reservoirs and sources of trypanosomes in Shimba Hills, we screened 696 trypanosome-infected and uninfected tsetse flies for vertebrate DNA using multiplegene PCR-High Resolution Melting analysis and amplicon sequencing. Results revealed that tsetse flies fed on 13 mammalian species, preferentially Phacochoerus africanus (warthogs) (17.39%, 95% CI: 14.56–20.21) and Bos taurus (cattle) (11.35%, 95% CI: 8.99–13.71). Some tsetse flies showed positive cases of bloodmeals from multiple hosts (3.45%, 95% CI: 2.09–4.81), including warthog and cattle (0.57%, 95% CI: 0.01–1.14). Importantly, tsetse flies that took bloodmeals from warthog had significant risk of infections with Trypanosoma vivax (5.79%, 95% CI: 1.57–10.00), T. congolense (7.44%, 95% CI: 2.70–12.18), and T. brucei sl (2.48%, 95% CI: 0.33–5.29). These findings implicate warthogs as important reservoirs of tsetse-borne trypanosomes affecting cattle in Shimba Hills and provide valuable epidemiological insights to underpin the parasites targeted management in Nagana vector control programs in the area.Table S1: Data on tsetse fly bloodmeal hosts and trypanosome infections in the different study-blocks in Shimba Hills, Kenya.Data Availability Statement: The dataset used and/or analysed during the current study are available from the corresponding author FIE on reasonable request. DNA sequences of vertebrate species generated during the current study are available in the GenBank under accession numbers: MZ816958-MZ816971.A German Academic Exchange Service (DAAD) in-region postgraduate scholarship; the BioVision Foundation Switzerland; European Union’s Integrated Biological Control Applied Research Programme—tsetse repellent component; the German Ministry for Economic Cooperation and Development (BMZ) through the Deutsche Gesellschaft für Internationale Zusammenarbeit; UK’s Department for International Development (DFID); Swedish International Development Cooperation Agency (SIDA); the Swiss Agency for Development and Cooperation (SDC); and the Kenyan Government.https://www.mdpi.com/journal/pathogensam2022Zoology and Entomolog

The effect of capacity building evidence-based medicine training on its implementation among healthcare professionals in Southwest Ethiopia: a controlled quasi-experimental outcome evaluation

Background: Evidence-based medicine (EBM) bridges research and clinical practice to enhance medical knowledge and improve patient care. However, clinical decisions in many African countries don’t base on the best available scientific evidence. Hence, this study aimed to determine the effect of training interventions on background knowledge and awareness of EBM sources, attitude, competence, and practice of EBM among healthcare professionals. Method: We designed a controlled group quasi-experimental pre-post test study to evaluate the effect of capacity-building EBM training. A total of 192 healthcare professionals were recruited in the study (96 from the intervention and 96 from the control group). We used a difference-in-differences (DID) analysis to determine the effect of the training. Along the way, we used a fixed effect panel-data regression model to assess variables that could affect healthcare professionals’ practice of EBM. The cut point to determine the significant effect of EBM training on healthcare professionals’ background knowledge and awareness of EBM sources, attitude, and competence was at a P-value < 0.05. Result: The DID estimator showed a significant net change of 8.0%, 17.1%, and 11.4% at P < 0.01 on attitude, competence, and practice of EBM, respectively, whereas no significant increment in the background knowledge and awareness of EBM sources. The fixed effect regression model showed that the attitude [OR = 2.288, 95% CI: (1.049, 4.989)], competence [OR = 4.174, 95% CI: 1.984, 8.780)], technical support [OR = 2.222, 95% CI: (1.043, 3.401)], and internet access [OR = 1.984, 95% CI: (1.073, 4.048)] were significantly affected EBM practice. Conclusion: The capacity-building training improved attitude, competence, and EBM practice. Policymakers, government, and other concerned bodies recommended focusing on a well-designed training strategy to enhance the attitude, competence, and practice towards EBM among healthcare professionals. It was also recommended to enhance internet access and set mechanisms to provide technical support at health facilities.publishedVersio

Comparative Proteomic Analysis of Mycobacterium tuberculosis Lineage 7 and Lineage 4 Strains Reveals Differentially Abundant Proteins Linked to Slow Growth and Virulence.

In order to decipher the nature of the slowly growing Mycobacterium tuberculosis (M.tuberculosis) lineage 7, the differentially abundant proteins in strains ofM. tuberculosis lineage 7 and lineage 4 were defined. Comparative proteomic analysis by mass spectrometry was employed to identify, quantitate and compare the protein profiles of strains from the two M. tuberculosis lineages. Label-free peptide quantification of whole cells from M. tuberculosis lineage 7 and 4 yielded the identification of 2825 and 2541 proteins, respectively. A combined total of 2867 protein groups covering 71% of the predicted M. tuberculosis proteome were identified. The abundance of 125 proteins in M. tuberculosis lineage 7 and 4 strains was significantly altered. Notably, the analysis showed that a number of M. tuberculosis proteins involved in growth and virulence were less abundant in lineage 7 strains compared to lineage 4. Five ABC transporter proteins, three phosphate binding proteins essential for inorganic phosphate uptake, and six components of the type 7 secretion system ESX-3 involved in iron acquisition were less abundant in M. tuberculosis lineage 7. This proteogenomic analysis provided an insight into the lineage 7-specific protein profile which may provide clues to understanding the differential properties of lineage 7 strains in terms of slow growth, survival fitness, and pathogenesis

Comparative Study of rK39 Leishmania Antigen for Serodiagnosis of Visceral Leishmaniasis: Systematic Review with Meta-Analysis

Visceral Leishmaniasis (VL) is a neglected tropical disease for which serodiagnostic tests are available, but not yet widely implemented in rural areas. The rK39 recombinant protein is derived from a kinesin-like protein of parasites belonging to the Leishmania donovani complex, and has been used in the last two decades for the serodiagnosis of VL. We present here a systematic review and meta-analysis of studies evaluating serologic assays (rK39 strip-test, rK39 ELISA, Direct Agglutination Test [DAT], Indirect Immunofluorescence test [IFAT] and ELISA with a promastigote antigen preparation [p-ELISA]) to diagnose VL to determine the accuracy of rK39 antigen in comparison to the use of other antigen preparations. Fourteen papers fulfilled the inclusion and exclusion selection criteria. The summarized sensitivity for the rK39-ELISA was 92% followed by IFAT 88% and p-ELISA 87%. The summarized specificity for the three diagnostic tests was 81%, 90%, and 77%. Studies comparing the rK39 strip test with DAT found a similar sensitivity (94%) and specificity (89%). However, the rK39 strip test was more specific than the IFAT and p-ELISA. In conclusion, we found the rK39 protein used either in a strip test or in an ELISA is a good choice for the serodiagnosis of VL