Introduction: Rickettsial infections are re-emerging diseases and are major causes of febrile illnesses throughout the Asia-Pacific region. It is difficult to diagnose due to the non-specific clinical manifestations, absence of reliable and affordable diagnostic tests thereby contributes to increasing the acute febrile burden and preventive illness in many populations. Undiagnosed or late-diagnosed cases are associated with high morbidity and mortality. Objectives: The study aimed to determine rickettsial disease by Weil-Felix test and to know the frequency of rickettsial diseases in febrile patients presenting to tertiary care hospitals in Dhaka, Bangladesh. Methods: In this study, a total of 135 peripheral blood samples were taken and tested by Weil Felix test from clinically suspected patients of rickettsial fever. Results: Weil- Felix test was positive in 33((24.4%) cases. Of Weil- Felix test-positive cases, OX-2 was positive in 87.87% cases, followed by OX-K (6.06%), OX-19 (3.03%), and both OX-2 & OX-K (3.03%) cases. OX-2 positive cases are suggestive of spotted fever group, OX-K of scrub typhus group, OX-19 of typhus group, and OX-2 & OX-K are suggestive of both spotted fever group and scrub typhus group. This finding suggests that most cases were infected with spotted fever group rickettsiae (SFGR). Conclusion: Analyzing the present study's findings, it may be concluded that rickettsial infection is not uncommon in Bangladesh. Weil-Felix test can be used in laboratories to diagnose rickettsial diseases where specific reliable serological or molecular test is not available.
Background: Rickettsial infections are re-emerging arthropods born worldwide zoonotic disease caused by Rickettsia, which is responsible for spotted fever and typhus fever. The diagnosis of a rickettsial illness is important for appropriate antibiotic treatment. Aims: The study aimed to determine the diagnostic accuracy and clinical usefulness of using nested polymerase chain reaction (PCR) by comparing nested PCR, ELISA, and Weil-Felix (WF) tests. Methodology: This was a prospective type of cross-sectional study. A total of 135 clinically suspected rickettsial infection cases were enrolled. Peripheral blood was taken to detect gltA, 17 kDa lipoprotein antigen gene (17 kDa), ompA, and ompB gene of Rickettsia by nested PCR. ELISA and Weil-Felix tests were done to compare with nested PCR. Results: Out of 135 cases, we detected Rickettsia in 70(51.85%) cases by nested PCR assay (p<0.01), 33((24.4%) by Weil- Felix test, 34 (25.18%) by ELISA. Only 26.66% of cases were PCR positive, which were negative by both ELISA and Weil-Felix test. Fifteen (11.11%) cases were positive by all three tests. Among 70 PCR positive rickettsia cases most frequently detected gene was ompB 42(60%), followed by 17kDa 34(48.58%); gltA 21(30%), and ompA 3(4.28%). Multiple gene combinations (ompB, 17kDa and gltA) detected in 98.57 % cases. Conclusion: Nested PCR assays showed the highest rate of detection of rickettsia cases than ELISA and Weil-Felix test. Multiple gene combinations (ompB, 17kDa, and gltA) showed the highest positivity. Therefore, diagnosis of rickettsial infection can be confirmed by PCR assay, and clinicians can plan appropriate treatment for these patients.
Background & Objective: This cross sectional study was carried out to assess the diagnostic value of PCR in different forms of leprosy. For the detection of Mycobacterium leprae, DNA amplification by polymerase chain reaction of a 531-bp fragment of the Mycobacterium leprae specific gene encoding the 36 kDA antigen. Methodology: It was done on different clinical specimens (slit smear of skin, ear lobule smear and nasal smear) from 50 leprosy patients attending the Leprosy Hospital, Mohakhali, Dhaka. Patients were divided into two groups; paucibacillary (70%) group and multibacillary (30%) group. PCR showed 100% positivity in skin and ear lobule and 73.4% positivity in nasal smear of multibacillary group. PCR was positive in 40%, 25.7% and 11.4% in skin lesion, ear lobule and nasal swab in paucibacillry group respectively. Result: Compared with other diagnostic procedures, PCR showed clear advantages over both modified Z-N stain and auramine-phenol stain especially in paucibacillary patients. Bangladesh J Med Microbiol 2020; 14 (1): 11-14
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