Diagnosis of Chlamydia trachomatis eye infection in Tanzania by polymerase chain reaction/enzyme immunoassay

Bobo, Linda; Muñoz, Beatriz; Viscidi, Raphael P.; Quinn, Thomas C.; Mkocha, Harran; West, SK

doi:10.1016/0140-6736(91)91502-l

Cited by 91 publications

(50 citation statements)

References 14 publications

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“…Conversely, assay-detectable infection sometimes persists in human conjunctival tissue after the resolution of (or without) clinical signs (28,194) (Fig. 5d) This can be termed persistent infection; unfortunately, there is no consistency in the literature in the use of this term.…”

Section: Correlation Of Laboratory Tests With Clinical Signs Of Trachomamentioning

confidence: 99%

“…They can be found in specimens obtained from the conjunctiva and from the urogenital tract (28,135,234). Inhibition may in some instances be overcome by prolonged storage prior to processing, which presumably allows time for degradation of the inhibitory factor (20,112,135), sample dilution (28,57,135,234), freezing at Ϫ70°C (57), or heat treatment at 95°C for 10 min (234). The Amplicor assay gives the user the additional option of monitoring each individual test for inhibition by including an internal control in each amplification reaction.…”

Section: Direct Hybridization Probe Testsmentioning

confidence: 99%

“…As a result, the MicroTrak has been widely used in trachoma research studies (28,31,55,57,100,135,189,210,217,240,242,244). Comparison between studies is made difficult by the fact that the threshold for defining a positive slide varies from one group of investigators to the next.…”

Section: Direct Fluorescent Antibodymentioning

confidence: 99%

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Diagnosis and Assessment of Trachoma

et al. 2004

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Trachoma is caused by Chlamydia trachomatis. Clinical grading with the WHO simplified system can be highly repeatable provided graders are adequately trained and standardized. At the community level, rapid assessments are useful for confirming the absence of trachoma but do not determine the magnitude of the problem in communities where trachoma is present. New rapid assessment protocols incorporating techniques for obtaining representative population samples (without census preparation) may give better estimates of the prevalence of clinical trachoma. Clinical findings do not necessarily indicate the presence or absence of C. trachomatis infection, particularly as disease prevalence falls. The prevalence of ocular C. trachomatis infection (at the community level) is important because it is infection that is targeted when antibiotics are distributed in trachoma control campaigns. Methods to estimate infection prevalence are required. While culture is a sensitive test for the presence of viable organisms and nucleic acid amplification tests are sensitive and specific tools for the presence of chlamydial nucleic acids, the commercial assays presently available are all too expensive, too complex, or too unreliable for use in national programs. There is an urgent need for a rapid, reliable test for C. trachomatis to assist in measuring progress towards the elimination of trachoma

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Section: Correlation Of Laboratory Tests With Clinical Signs Of Trachomamentioning

confidence: 99%

Section: Direct Hybridization Probe Testsmentioning

confidence: 99%

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Diagnosis and Assessment of Trachoma

et al. 2004

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“…The average and standard deviation for the pooled negative0control replicates from each run were calculated. Due to the potential for day-to-day interrun variability, the cutoff C T value for each run was defined as 3 standard deviations below the negative-control average (1). Any sample with a C T value higher than the cutoff value was considered PCR negative and vice versa.…”

Section: Pcr Assay Algorithmmentioning

confidence: 99%

Rapid PCR-Based Diagnosis of Septic Arthritis by Early Gram-Type Classification and Pathogen Identification

et al. 2008

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Septic arthritis (SA) is a rheumatologic emergency associated with significant morbidity and mortality. Delayed or inadequate treatment of SA can lead to irreversible joint destruction and disability. Current methods of diagnosing SA rely on synovial fluid analysis and culture which are known to be imprecise and time-consuming. We report a novel adaptation of a probe-based real-time PCR assay targeting the 16S rRNA gene for early and accurate diagnosis of bacterial SA. The assay algorithm consists of initial broad-range eubacterial detection, followed by Gram typing and species characterization of the pathogen. The platform demonstrated a high analytical sensitivity with a limit of detection of 10 1 CFU/ml with a panel of SA-related organisms. Gram typing and pathogen-specific probes correctly identified their respective targets in a mock test panel of 36 common clinically relevant pathogens. One hundred twenty-one clinical synovial fluid samples from patients presenting with suspected acute SA were tested. The sensitivity and specificity of the assay were 95% and 97%, respectively, versus synovial fluid culture results. Gram-typing probes correctly identified 100% of eubacterial positive samples as to gram-positive or gram-negative status, and pathogen-specific probes correctly identified the etiologic agent in 16/20 eubacterial positive samples. The total assay time from sample collection to result is 3 h. We have demonstrated that a real-time broad-based PCR assay has high analytical and clinical performance with an improved time to detection versus culture for SA. This assay may be a useful diagnostic adjunct for clinicians, particularly those practicing in the acute care setting where rapid pathogen detection and identification would assist in disposition and treatment decisions.Septic arthritis (SA) is a rheumatologic emergency associated with significant morbidity and mortality (6, 9). Delayed or inadequate treatment of SA can lead to irreversible joint destruction with subsequent disability. Accordingly, prompt diagnosis and early initiation of therapy are critical in improving the outcome (7).The diagnosis of SA in the acute care setting is challenging because of the relatively poor sensitivity and specificity of clinical examination findings and lack of a rapid reliable diagnostic assay. Further, overreliance on conventional laboratory tests for synovial fluid analysis is hindered by the relatively poor performance characteristics of these methods (11,12,16). In particular, the sensitivity of Gram staining has been reported in the range of 29% to 50% (3, 4), and the sensitivity of culture may be only 82% (9). Lack of a rapid and accurate diagnostic tool results in acute care clinicians often choosing the conservative approach of hospital admission and empirical broadspectrum antibiotics for patients with suspected SA. The benefits of this management strategy may be offset, however, by added costs and potential iatrogenic complications associated with unnecessary treatment and hospitalizations, as well ...

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“…In general, poor hygienic conditions favor the transmission of C. trachomatis through contact with infectious secretions, 42 with exposure to the ocular and nasal secretions of pre-school children clearly a potential source of infection. 35,43 Several investigations have been carried out on the impact of unclean faces in children, and the value of face washing, on trachoma.…”

Section: Review Of the Safe Strategymentioning

confidence: 99%

Blinding Trachoma: Prevention With the Safe Strategy

West

2003

The American Journal of Tropical Medicine and Hygiene

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Abstract. Trachoma, the second leading cause of blindness worldwide, differentially affects the poorest communities, which may have the least access to resources. With the establishment of the Global Elimination of Blinding Trachoma by 2020 (GET 2020) goal, the World Health Organization has set an ambitious target for country programs. The currently recommended surgery for trichiasis/entropion, antibiotics for active disease, facial cleanliness, and environmental change to reduce transmission (SAFE) strategy targets all key elements believed to be necessary for a short-and long-term intervention program. This report reviews the need for a multi-faceted strategy, and the evidence supporting the elements of SAFE. Concerns about the implementation are discussed. Additional research is suggested that will enhance the implementation of the SAFE strategy. In the current climate of significant political and social momentum for trachoma control, the SAFE strategy is a safe bet to accomplish the elimination of blinding trachoma.

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Diagnosis of Chlamydia trachomatis eye infection in Tanzania by polymerase chain reaction/enzyme immunoassay

Cited by 91 publications

References 14 publications

Diagnosis and Assessment of Trachoma

Diagnosis and Assessment of Trachoma

Rapid PCR-Based Diagnosis of Septic Arthritis by Early Gram-Type Classification and Pathogen Identification

Blinding Trachoma: Prevention With the Safe Strategy

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