Clinical Evaluation of the OneStep Gonorrhea RapiCard InstaTest for Detection of Neisseria gonorrhoeae in Symptomatic Patients from KwaZulu-Natal, South Africa: TABLE 1

We evaluated a point-of-care test for the detection ofNeisseria gonorrhoeaein patients attending a public health clinic in KwaZulu-Natal, South Africa. The test showed a low sensitivity against PCR and culture (<40%); however, a higher specificity was observed (>95%). This test is unsuitable as a screening tool for gonorrhea.

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Auditing the use and assessing the clinical utility of microscopy as a point-of-care test for Neisseria gonorrhoeae in a Sexual Health clinic

International Journal of STD & AIDS ◽

10.1177/0956462417721062 ◽

2017 ◽

Vol 29 (2) ◽

pp. 157-163 ◽

Cited By ~ 5

Author(s):

Sarah Mensforth ◽

Nicola Thorley ◽

Keith Radcliffe

Keyword(s):

Neisseria Gonorrhoeae ◽

Clinical Utility ◽

Point Of Care ◽

Nucleic Acid Amplification ◽

Contact Tracing ◽

Health Clinic ◽

Exact Test ◽

Point Of Care Test ◽

Sex With Men ◽

Prompt Diagnosis

We assessed whether urethral microscopy was performed as per clinic protocol for male clinic attendees reporting contact with Neisseria gonorrhoeae (GC), urethral symptoms or given a diagnosis of epididymo-orchitis (EO) over a 12-month period (9732 patients). Prevalence of gonorrhoea in the contacts, urethral symptoms and EO groups was 50, 12.7 and 1.6%, respectively. Microscopy was performed reliably for contacts (96%), those with discharge/dysuria with evidence of urethritis on examination (98%), but not those with EO (43%). We explored the clinical utility of microscopy as a point-of-care test for identifying urethral GC in each subgroup, using the APTIMA Combo 2 CT/GC nucleic acid amplification test as the comparator (1710 patients). Sensitivity of microscopy for each subgroup was good; there was no statistical difference between subgroup sensitivity using Fisher’s exact test. Microscopy is valuable to ensure prompt diagnosis and contact tracing. All GC contacts were treated ‘epidemiologically’; however, half of GC contacts did not have GC. Microscopy identified the majority of GC cases, including amongst contacts (71% of heterosexual contacts, 66% of contacts reporting sex with men). We propose that epidemiological treatment for GC contacts should be reconsidered on the grounds of antibiotic stewardship, favouring use of microscopy to guide treatment decisions.

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Genome Sequences of Five Novel Neisseria gonorrhoeae Sequence Types Isolated in KwaZulu-Natal, South Africa

Microbiology Resource Announcements ◽

10.1128/mra.01424-20 ◽

2021 ◽

Vol 10 (9) ◽

Author(s):

Nireshni Mitchev ◽

Mushal Allam ◽

Stanford Kwenda ◽

Florah Mnyameni ◽

Arshad Ismail ◽

...

Keyword(s):

South Africa ◽

Neisseria Gonorrhoeae ◽

Genome Sequences ◽

Content Type ◽

Kwazulu Natal ◽

Sequence Types

ABSTRACT Africa has the highest incidence of Neisseria gonorrhoeae infections globally, but data on these isolates is scarce. Here, we report six N. gonorrhoeae genome sequences with five novel sequence types isolated from patients with uncomplicated genitourinary gonorrhea in South Africa.

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Antimicrobial resistance mechanisms, MLST and NG-STAR sequence types of diverse Neisseria gonorrhoeae isolates in KwaZulu-Natal, South Africa

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00759-21 ◽

2021 ◽

Author(s):

Nireshni Mitchev ◽

Ravesh Singh ◽

Mushal Allam ◽

Stanford Kwenda ◽

Arshad Ismail ◽

...

Keyword(s):

South Africa ◽

Antimicrobial Resistance ◽

Neisseria Gonorrhoeae ◽

Point Mutations ◽

Resistance Mechanisms ◽

Public Healthcare ◽

Multiple Sequence ◽

Genotypic Analysis ◽

Kwazulu Natal ◽

Sequence Types

Objective: Antimicrobial resistance (AMR) is a major challenge to managing infectious diseases. Africa has the highest incidence of gonorrhoea but there is a lack of comprehensive data from sparse surveillance programs. This study investigated the molecular epidemiology and AMR profiles of Neisseria gonorrhoeae isolates in KwaZulu-Natal province (KZN), South Africa. Methods: Repository isolates, from patients attending public healthcare clinics for STI care, were used for phenotypic and genotypic analysis. Etest® was performed to determine antimicrobial susceptibility. Whole-genome sequencing (WGS) was used to determine epidemiology and to predict susceptibility by detecting resistance-associated genes and mutations. Results: Among the 61 isolates, multiple sequence types were identified. Six isolates were novel as determined by multilocus sequence typing. N.gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) determined 48 sequence types, of which 35 isolates had novel antimicrobial profiles. Two novel penA alleles and eight novel mtrR alleles were identified. Point mutations were detected in gyrA , parC , mtrR , penA , ponA and porB1 . This study revealed a high prevalence of AMR (penicillin 67%, tetracycline 89% and ciprofloxacin 52%). However, spectinomycin, cefixime, ceftriaxone and azithromycin remained 100% effective. Conclusion: This study is one of the first to comprehensively describe the epidemiology and AMR of N. gonorrhoeae in KZN, South Africa and Africa, using WGS. KZN has a wide strain diversity and most of these sequence types have been detected in multiple countries, however more than half of our isolates have novel antimicrobial profiles. Continued surveillance is crucial to monitor the emergence of resistance to cefixime, ceftriaxone and azithromycin.

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Diagnostic tests for detecting Chlamydia trachomatis and Neisseria gonorrhoeae in rectal and pharyngeal specimens

Journal of Clinical Microbiology ◽

10.1128/jcm.00211-21 ◽

2021 ◽

Author(s):

Paul C. Adamson ◽

Jeffrey D. Klausner

Keyword(s):

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Bacterial Infections ◽

Point Of Care ◽

High Sensitivity ◽

Population Level ◽

The United States ◽

Nucleic Acid Amplification ◽

Point Of Care Test ◽

Control And Prevention

Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.

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PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v17i1.444 ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Mandisa Skhosana ◽

Shabashini Reddy ◽

Tarylee Reddy ◽

Siphelele Ntoyanto ◽

Elizabeth Spooner ◽

...

Keyword(s):

South Africa ◽

T Cells ◽

T Cell ◽

Antiretroviral Therapy ◽

Cell Count ◽

Point Of Care ◽

Cd4 T Cell ◽

Cell Counts ◽

Kwazulu Natal ◽

Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

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Protected areas and environmental conservation in KwaZulu-Natal, South Africa: on HEIs, livelihoods and sustainable development

International Journal of Sustainability in Higher Education ◽

10.1108/ijshe-05-2020-0157 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Inocent Moyo ◽

Hlengiwe Marvelous Sweetness Cele

Keyword(s):

South Africa ◽

Sustainable Development ◽

Rural Communities ◽

Indigenous Communities ◽

Environmental Conservation ◽

Developmental Needs ◽

Content Type ◽

Research And Innovation ◽

Kwazulu Natal ◽

Micro Level

Purpose The paper aims to advocate for innovative approaches in terms of the involvement of higher education institutions (HEIs) in the conservation of the environment, which fully considers and includes the developmental needs of indigenous communities while at the same time protecting the environment. Design/methodology/approach Using a qualitative study of indigenous communities and protected area (PA) authorities in Okhahlamba-Drakensberg, KwaZulu-Natal, South Africa, this paper explores the potential of the engagement of HEIs in capacitating indigenous communities to unleash their development potential towards reducing poverty and, thus accelerating the implementation of sustainable development goal one (SDG 1). Findings The paper shows that the enforcement of stringently protectionist policies in environmental conservation in PAs does very little to address issues of poverty because it leads to the marginalisation of indigenous communities and thereby their exclusion from using resources, which should benefit them. This undermines sustainable development, particularly the attainment of SDGs such as Goal 1, which targets ending poverty in all its forms everywhere. Originality/value Using the case of environmental management and governance of a PA in KwaZulu-Natal, South Africa, this paper highlights the fact that the attainment of SDG 1 can start at a micro-level and HEIs have a role to play in terms of collaborating with and understanding the needs of the rural communities so that research and innovation are geared towards meeting such needs. In this way, the paper advances the case of how the HEI-rural community-SDG 1 nexus can be established.

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Two serological approaches for detection of antibodies to SARS-CoV-2 in different scenarios: a screening tool and a point-of-care test

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2020.115167 ◽

2020 ◽

Vol 98 (4) ◽

pp. 115167 ◽

Cited By ~ 4

Author(s):

Alexis C.R. Hoste ◽

Angel Venteo ◽

Alba Fresco-Taboada ◽

Istar Tapia ◽

Alejandro Monedero ◽

...

Keyword(s):

Screening Tool ◽

Point Of Care ◽

Point Of Care Test

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AnemoCheck-LRS: an optimized, color-based point-of-care test to identify severe anemia in limited-resource settings

BMC Medicine ◽

10.1186/s12916-020-01793-6 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Marina S. Perez-Plazola ◽

Erika A. Tyburski ◽

Luke R. Smart ◽

Thad A. Howard ◽

Amanda Pfeiffer ◽

...

Keyword(s):

Screening Tool ◽

Point Of Care ◽

Low Cost ◽

Limited Resource ◽

Absolute Difference ◽

Severe Anemia ◽

Detection Range ◽

Point Of Care Test ◽

Colour Scale ◽

Life Saving

Abstract Background Severe anemia is common and frequently fatal for hospitalized patients in limited-resource settings. Lack of access to low-cost, accurate, and rapid diagnosis of anemia impedes the delivery of life-saving care and appropriate use of the limited blood supply. The WHO Haemoglobin Colour Scale (HCS) is a simple low-cost test but frequently inaccurate. AnemoCheck-LRS (limited-resource settings) is a rapid, inexpensive, color-based point-of-care (POC) test optimized to diagnose severe anemia. Methods Deidentified whole blood samples were diluted with plasma to create variable hemoglobin (Hb) concentrations, with most in the severe (≤ 7 g/dL) or profound (≤ 5 g/dL) anemia range. Each sample was tested with AnemoCheck-LRS and WHO HCS independently by three readers and compared to Hb measured by an electronic POC test (HemoCue 201+) and commercial hematology analyzer. Results For 570 evaluations within the limits of detection of AnemoCheck-LRS (Hb ≤ 8 g/dL), the average difference between AnemoCheck-LRS and measured Hb was 0.5 ± 0.4 g/dL. In contrast, the WHO HCS overestimated Hb with an absolute difference of 4.9 ± 1.3 g/dL for samples within its detection range (Hb 4–14 g/dL, n = 405). AnemoCheck-LRS was much more sensitive (92%) for the diagnosis of profound anemia than WHO HCS (22%). Conclusions AnemoCheck-LRS is a rapid, inexpensive, and accurate POC test for anemia. AnemoCheck-LRS is more accurate than WHO HCS for detection of low Hb levels, severe anemia that may require blood transfusion. AnemoCheck-LRS should be tested prospectively in limited-resource settings where severe anemia is common, to determine its utility as a screening tool to identify patients who may require transfusion.

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