Background: The diagnostic test for malaria is mostly based on Rapid Diagnostic Test (RDT) and detection by microscopy. Polymerase Chain Reaction (PCR) is also a sensitive detection method that can be considered as a diagnostic tool. The outcome of malaria microscopy detection depends on the examiner's ability and experience. Some RDT has been distributed in Indonesia, which needs to be evaluated for their results. Objective: This study aimed to compare the performance of RightSign RDT and ScreenPlus RDT for detection of Plasmodium in human blood. We used specific real-time polymerase chain reaction abTESTMMalaria qPCRII) and gold standard of microscopy detection method to measure diagnostic efficiency. Methods: Blood specimens were evaluated using RightSign RDT, ScreenPlus RDT, Microscopy detection, and RT-PCR as the protocol described. The differences on specificity (Sp), sensitivity (Sn), positive predictive value (PPV), and negative predictive value (NPV) were analyzed using McNemar and Kruskal Wallis analysis. Results: A total of 105 subjects were recruited. Based on microscopy test, RightSign RDT had sensitivity, Specificity, PPV, NPV, 100%, 98%, 98.2%, 100%, respectively. ScreenPlus showed 100% sensitivity, 98% specificity, 98.2% PPV, 100% NPV. The sensitivity of both RDTs became lower (75%) and the specificity higher (100 %) when using real-time PCR. Both RDTs showed a 100% agreement. RT-PCR detected higher mix infection when compared to microscopy and RDTs. Conclusion: RightSign and ScreenPlus RDT have excellent performance when using microscopy detection as a gold standard. Real-time PCR method can be considered as a confirmation tool for malaria diagnosis.
The diagnosis of viral dengue infection is very important for the management of dengue patients. In acute phase infection circulatingNS1 antigen can be detected in the sera of patients with dengue viral infection. This study is evaluating the NS1 antigen level in denguepatients using antigen captured ELISA Platelia TM Dengue NS1 Ag (Bio-Rad Laboratories). In this 30 examined dengue patients consistingof 3(10%) undifferentiated fever, 10(33.33%) dengue fever, 12(40%) DHF grade I, 2(6.66%) DHF grade II, 2(6.66%) DHF gradeIII, 1(3.33%) DHF grade IV. The result revealed that NS1 antigen was positive in 12 among 30 patients (40%) which were diagnosedas Dengue Viral infection based on 1997 WHO criteria. The sensitivity of NS1 antigen in these patients as confirmed with IgM andIgG antidengue serology test was 52.2%. The highest positivism of NS1 antigen was on the third day of fever. The results analyzed bySpearman correlation test revealed that there was no significant correlation between NS1 antigen level and the severity of dengue viralinfection. The cut-off value of quantitative NS1 antigen could not be determined because they were no significant correlation shown forNS1 antigen as the predictor for the severity of dengue viral infection. The conclusion of the study so far shown that the quantitativeNS1 antigen level could not be used as the predictor for the severity of dengue viral infection. The cut-off value of quantitative NS1antigen could not be determined because there were no significant correlation shown for NS1 antigen as the predictor for the severityof dengue viral infection.
The gold standard for TB still has some drawbacks, such as a long duration for culture examination and the rolated facilities are notalways available in all laboratories. One of methods in diagnosing tuberculosis infection is by immunochromatography (ICT). MYCOTECTB xp (recombinant) is one of serologic tests using immunochromatography principle. MYCOTEC TB xp uses recombinant antigens 38kDa, 16 kDa, 6 kDa and Early Secreted Antigen Target (ESAT-6). This method is expected so far diagnose TB in a short time and has ahigh accuracy. Evaluating the immunochromatography method in detecting antibody by tuberculosis antigen in lung TB patients as willthose with nonTB lung disease (lung tumor, bronchial asthma, pneumonia, chronic obstructive lungdisease). Serum samples of 30 TBpatients in BP4/Karang Tembok Hospital Surabaya and 30 non TB patients in the Dr. Soetomo Hospital Surabaya. Detection of antibodyto tuberculosis antigen was done with MYCOTEC TB xp. In this study found is prond 30 TB patients using MYCOTEC TB xp was positivein 23 samples and negative in 7 samples. From the 30 nonTB patients MYCOTEC TB xp was positive in 4 samples and negative in 26samples. It can be uncloaded so far that the diagnostic sensitivity of MYCOTEC TB xp was 76.7% (23/30) and diagnostic specificity was86.7% (26/30). MYCOTEC TB xp has an intermediate diagnostic sensitivity of 76.7% and a high diagnostic specificity of 86.7%.
Approximately 10-15% of COVID-19 patients become severely ill and require intensive care. One of the laboratory tests used in monitoring patients in the ICU is D-dimer. Elevated levels of D-dimer can predict the disease severity and mortality. The aim of this study was to analyze the relationship between D-dimer levels and ICU length of stay in patients with COVID-19.This was an analytical observational study with a cross-sectional design and a retrospective approach. The secondary data were in the form of confirmed COVID-19 patients at Dr. Soetomo General Hospital Surabaya from April 2020 to March 2021.The median of continuous variables was compared with the Mann-Whitney U test. The correlation was determined using the Spearman's Rank Correlation Coefficient test. Based on the criteria, it was obtained a sample of 120 patients with the median of initial D-dimer 2225 (855 -6122.5) ng/mL FEU and the median duration of the ICU stay 9 (1 -32) days. The result of the comparative analysis of the initial D-dimer levels on clinical outcomes indicated a p-value of 0.012. Patients with life clinical outcomes showed a relationship between initial D-dimer levels and the length of ICU stay (p = 0.328; (r 2 ) = 0.309) while in patients with death clinical outcomes was (p =0.023; (r 2 ) = -0.219). Elevated D-dimer levels as a marker of thrombosis were reported. Increased D-dimer levels correlated with mortality. Thus, there was a correlation between initial D-dimer levels and length of ICU stay in COVID-19 patients with death clinical outcome.
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