The utility of multiplex polymerase chain reaction for diagnosis of infectious diarrhoea in a tropical country

Ghoshal, Ujjala; Tejan, Nidhi; Sisodia, Juhi; Verma, Shikha; Prasad, Narayan

doi:10.1016/j.ijmmb.2021.03.024

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…We searched the Medline database and retrieved a total of 596 studies. We included 27 articles and our own experience to set up a brief narrative review on the use of syndromic panels for virus-associated AGE in tropical regions [ 5 , 6 , 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Exclusion criteria were population outside LMIC and singleplex PCR; we did not apply any year filters or age restrictions to the target population.…”

Section: Methodsmentioning

confidence: 99%

“…These technical prerequisites obviously limit their application in remote and/or resource-limited regions. However, a recent study showed that the detection rate increased over conventional methods [ 12 ]. A real-time PCR system is not available in many tropical regions due to cost, lack of equipment, and high technical demand on the staff, and therefore, the data on the routine use of PCR for AGE diagnosis are limited [ 25 ].…”

Section: Technical and Pre-analytical Considerationsmentioning

confidence: 99%

“…Patients may benefit from rapid and appropriate diagnosis, avoiding erroneous prescription of antibiotics, concomitant side effects, and antibiotic-resistance related issues. Of note, a study with 414 patients performed in India using a molecular multiplex panel registered the use of antibiotics in 90% of patients with a viral causative agent [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute Viral Gastrointestinal (GI) Infections in the Tropics—A Role for Cartridge-Based Multiplex PCR Panels?

et al. 2022

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Acute gastroenteritis (AGE) contributes to increased morbidity and mortality worldwide. In particular, children in resource-poor settings suffer from frequent episodes of diarrhea. A variety of pathogens, including bacteria, viruses, fungi, and protozoa, can cause AGE. Common viruses associated with AGE are norovirus, rotavirus, astrovirus, adenovirus, and sapovirus. Due to their similar clinical presentation, AGE pathogens cannot be distinguished on clinical grounds rendering the etiological diagnosis challenging. However, reliable diagnosis is essential for individual and public health reasons, e.g., to limit transmission, for appropriate antibiotic use, prognostic appreciation, and vaccination programs. Therefore, high-quality data derived by accurate diagnostics are important to improve global health. In Western industrialized countries, diagnosis relies on microbiological testing, including culture methods, microscopy, immunochromatography, and single-target molecular methods. Recently, multiplex PCR or syndromic panels have been introduced, which simultaneously analyze for multiple pathogens in a very short time. A further technological advancement is cartridge-based syndromic panels, which allow for near patient/point-of-care testing independently from a laboratory. In resource-poor tropical regions, however, laboratory diagnosis is rarely established, and there are little routine laboratory data on the epidemiology of viral AGE pathogens. Limiting factors for the implementation of syndromic panels are high costs, sophisticated equipment, and the need for trained personnel. In addition, pilot studies have shown a large number of viral (co-)detections among healthy controls, thus further challenging their clinical utilization. Hence, there are little evidence-based data on the impact of multiplex syndromic panels from resource-limited regions. Here, we aim to provide a brief overview of what is known about the use of syndromic panels for virus-associated AGE in tropical regions and to address future challenges.

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