Journal Article > ResearchFull Text
Lancet. 1997 January 18; Volume 349 (Issue 9046); DOI:10.1016/S0140-6736(05)60961-0
Boelaert M, Henkens M
Lancet. 1997 January 18; Volume 349 (Issue 9046); DOI:10.1016/S0140-6736(05)60961-0
Journal Article > ResearchFull Text
Am J Trop Med Hyg. 2018 February 22; Volume 98 (Issue 4); 1091–1101.; DOI:10.4269/ajtmh.17-0872
Sunyoto T, Adam GK, Atia AM, Hamid Y, Babiker RA, et al.
Am J Trop Med Hyg. 2018 February 22; Volume 98 (Issue 4); 1091–1101.; DOI:10.4269/ajtmh.17-0872
Early diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used. Our study participants revealed the multitude of difficulties faced when seeking care. The disease is well known in the area, yet misconceptions about causes and transmission persist. The care-seeking itineraries were not always straightforward: "shopping around" for treatments are common, partly linked to difficulties in diagnosing kala-azar. Kala-azar is perceived to be "hiding," requiring multiple tests and other diseases must be treated first. Negative perceptions on quality of care in the public hospitals prevail, with the unavailability of drugs or staff as the main concern. Delay to seek care remains predominantly linked to economic constraint: albeit treatment is for free, patients have to pay out of pocket for everything else, pushing families further into poverty. Despite increased efforts to tackle the disease over the years, access to quality kala-azar care in this rural Sudanese context remains problematic. The barriers explored in this study are a compelling reminder of the need to boost efforts to address these barriers.
Journal Article > ResearchFull Text
Clin Infect Dis. 2015 June 30 (Issue 8)
Mahajan R, Das P, Isaakidis P, Sunyoto T, Sagili KD, et al.
Clin Infect Dis. 2015 June 30 (Issue 8)
There are considerable numbers of patients co-infected with Human Immunodeficiency Virus (HIV) and Visceral Leishmaniasis (VL) in the VL-endemic areas of Bihar, India. These patients are at higher risk of relapse and death, but there are still no evidence-based guidelines on how to treat them. In this study, we report on treatment outcomes of co-infected patients up to 18 months following treatment with a combination regimen.
Journal Article > ResearchFull Text
Trop Med Int Health. 2004 August 1; Volume 9 (Issue 8); DOI:10.1111/j.1365-3156.2004.01266.x
Robays J, Ebeja Kadima A, Lutumba P, Miaka mia Bilenge C, Kande Betu Ku Mesu V, et al.
Trop Med Int Health. 2004 August 1; Volume 9 (Issue 8); DOI:10.1111/j.1365-3156.2004.01266.x
BACKGROUND: Increasing numbers of human African trypanosomiasis (HAT) cases have been reported in urban residents of Kinshasa, Democratic Republic Congo since 1996. We set up a case-control study to identify risk factors for the disease. METHODS: All residents of the urban part of Kinshasa with parasitologically confirmed HAT and presenting for treatment to the city's specialized HAT clinics between 1 August, 2002 and 28 February, 2003 were included as cases. We defined the urban part as the area with contiguous habitation and a population density >5000 inhabitants per square kilometre. A digital map of the area was drawn based on a satellite image. For each case, two serologically negative controls were selected, matched on age, sex and neighbourhood. Logistic regression models were fitted to control for confounding. RESULTS: The following risk factors were independently associated with HAT: travel, commerce and cultivating fields in Bandundu, and commerce and cultivating fields in the rural part of Kinshasa. No association with activities in the city itself was found. DISCUSSION: In 2002, the emergence of HAT in urban residents of Kinshasa appears mainly linked to disease transmission in Bandundu and rural Kinshasa. We recommend to intensify control of these foci, to target HAT screening in urban residents to people with contact with these foci, to increase awareness of HAT amongst health workers in the urban health structures and to strengthen disease surveillance.
Journal Article > LetterFull Text
Lancet. 1997 June 14; Volume 349 (Issue 9067); 1775.; DOI:10.1016/s0140-6736(05)62998-4
Boelaert M, Englebert M, Hanquet G, Van Damme W, Van der Stuyft P
Lancet. 1997 June 14; Volume 349 (Issue 9067); 1775.; DOI:10.1016/s0140-6736(05)62998-4
Journal Article > LetterSubscription Only
JAMA. 2002 February 20; Volume 287 (Issue 7); 840-843.; DOI:10.1001/jama.287.7.840
Boelaert M, Lynen L, Van Damme W, Colebunders R
JAMA. 2002 February 20; Volume 287 (Issue 7); 840-843.; DOI:10.1001/jama.287.7.840
Journal Article > ResearchFull Text
PLoS Negl Trop Dis. 2014 June 26; Volume 8 (Issue 6); e2869.; DOI:10.1371/journal.pntd.0002869
Diro EGJ, Lynen L, Ritmeijer KKD, Boelaert M, Hailu ADE, et al.
PLoS Negl Trop Dis. 2014 June 26; Volume 8 (Issue 6); e2869.; DOI:10.1371/journal.pntd.0002869
Visceral Leishmaniasis (VL) is an important protozoan opportunistic disease in HIV patients in endemic areas. East Africa is second to the Indian subcontinent in the global VL caseload and first in VL-HIV coinfection rate. Because of the alteration in the disease course, the diagnostic challenges, and the poor treatment responses, VL with HIV coinfection has become a very serious challenge in East Africa today. Field experience with the use of liposomal amphotericin B in combination with miltefosine, followed by secondary prophylaxis and antiretroviral drugs, looks promising. However, this needs to be confirmed through clinical trials. Better diagnostic and follow-up methods for relapse and prediction of relapse should also be looked for. Basic research to understand the immunological interaction of the two infections may ultimately help to improve the management of the coinfection.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 2012 December 13; Volume 6 (Issue 12); DOI:10.1371/journal.pntd.0001950
Hasker E, Lutumba P, Chappuis F, Kande V, Potet J, et al.
PLoS Negl Trop Dis. 2012 December 13; Volume 6 (Issue 12); DOI:10.1371/journal.pntd.0001950
Journal Article > ResearchAbstract Only
J Vector Borne Dis. 2021 July 1; DOI:10.4103/0972-9062.321747
Mahajan R, Nair MM, Saldanha AM, Harshana A, de Lima Pereira A, et al.
J Vector Borne Dis. 2021 July 1; DOI:10.4103/0972-9062.321747
BACKGROUND AND OBJECTIVES
There is limited evidence regarding the accuracy of dengue rapid diagnostic kits despite their extensive use in India. We evaluated the performance of four immunochromatographic Rapid Diagnostic Test (RDTs) kits: Multisure dengue Ab/Ag rapid test (MP biomedicals; MP), Dengucheck combo (Zephyr Biomedicals; ZB), SD bioline dengue duo (Alere; SD) and Dengue day 1 test (J Mitra; JM).
METHODS
This is a laboratory-based diagnostic evaluation study. Rapid tests results were compared to reference non-structural (NS1) antigen or immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) results of 241 dengue-positive samples and 247 dengue-negative samples. Sensitivity and specificity of NS1 and IgM components of each RDT were calculated separately and in combination (either NS1 or IgM positive) against reference standard ELISA.
RESULTS
A total of 238, 226, 208, and 146 reference NS1 ELISA samples were tested with MP, ZB, SD, and JM tests, respectively. In comparison to the NS1 ELISA reference tests, the NS1 component of MP, ZB, SD, and JM RDTs demonstrated a sensitivity of 71.8%, 85.1%, 77.2% and 80.9% respectively and specificity of 90.1%, 92.8%, 96.1 %, and 93.6%, respectively. In comparison to the IgM ELISA reference test, the IgM component of RDTs showed a sensitivity of 40.0%, 50.3%, 47.3% and 20.0% respectively and specificity of 92.4%, 88.6%, 96.5%, and 92.2% respectively. Combining NS1 antigen and IgM antibody results led to sensitivities of 87.5%, 82.9%, 93.8% and 91.7% respectively, and specificities of 75.3%, 73.9%, 76.5%, and 80.0% respectively.
INTERPRETATION & CONCLUSIONS
Though specificities were acceptable, the sensitivities of each test were markedly lower than manufacturers' claims. These results also support the added value of combined antigen-and antibody-based RDTs for the diagnosis of acute dengue.
There is limited evidence regarding the accuracy of dengue rapid diagnostic kits despite their extensive use in India. We evaluated the performance of four immunochromatographic Rapid Diagnostic Test (RDTs) kits: Multisure dengue Ab/Ag rapid test (MP biomedicals; MP), Dengucheck combo (Zephyr Biomedicals; ZB), SD bioline dengue duo (Alere; SD) and Dengue day 1 test (J Mitra; JM).
METHODS
This is a laboratory-based diagnostic evaluation study. Rapid tests results were compared to reference non-structural (NS1) antigen or immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) results of 241 dengue-positive samples and 247 dengue-negative samples. Sensitivity and specificity of NS1 and IgM components of each RDT were calculated separately and in combination (either NS1 or IgM positive) against reference standard ELISA.
RESULTS
A total of 238, 226, 208, and 146 reference NS1 ELISA samples were tested with MP, ZB, SD, and JM tests, respectively. In comparison to the NS1 ELISA reference tests, the NS1 component of MP, ZB, SD, and JM RDTs demonstrated a sensitivity of 71.8%, 85.1%, 77.2% and 80.9% respectively and specificity of 90.1%, 92.8%, 96.1 %, and 93.6%, respectively. In comparison to the IgM ELISA reference test, the IgM component of RDTs showed a sensitivity of 40.0%, 50.3%, 47.3% and 20.0% respectively and specificity of 92.4%, 88.6%, 96.5%, and 92.2% respectively. Combining NS1 antigen and IgM antibody results led to sensitivities of 87.5%, 82.9%, 93.8% and 91.7% respectively, and specificities of 75.3%, 73.9%, 76.5%, and 80.0% respectively.
INTERPRETATION & CONCLUSIONS
Though specificities were acceptable, the sensitivities of each test were markedly lower than manufacturers' claims. These results also support the added value of combined antigen-and antibody-based RDTs for the diagnosis of acute dengue.
Journal Article > EditorialFull Text
Trop Med Int Health. 2002 December 11; Volume 7 (Issue 12); 1001-1002.; DOI:10.1046/j.1365-3156.2002.00972.x
Boelaert M, Van Damme W, Meessen B, Van der Stuyft P
Trop Med Int Health. 2002 December 11; Volume 7 (Issue 12); 1001-1002.; DOI:10.1046/j.1365-3156.2002.00972.x