scholarly journals The good and the bad: using C reactive protein to distinguish bacterial from non-bacterial infection among febrile patients in low-resource settings

2020 ◽  
Vol 5 (5) ◽  
pp. e002396 ◽  
Author(s):  
Camille Escadafal ◽  
Sandra Incardona ◽  
B Leticia Fernandez-Carballo ◽  
Sabine Dittrich
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Bacterial Infections ◽  
Laboratory Diagnostics ◽  
Antibiotic Prescribing ◽  
Health Coverage ◽  
C Reactive Protein ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein

C reactive protein (CRP), a marker for the presence of an inflammatory process, is the most extensively studied marker for distinguishing bacterial from non-bacterial infections in febrile patients. A point-of-care test for bacterial infections would be of particular use in low-resource settings where other laboratory diagnostics are not always available, antimicrobial resistance rates are high and bacterial infections such as pneumonia are a leading cause of death. This document summarises evidence on CRP testing for bacterial infections in low-income and middle-income countries (LMICs). With a push for universal health coverage and prevention of antimicrobial resistance, it is important to understand if CRP might be able to do the job. The use of CRP polarised the global health community and the aim of this document is to summarise the ‘good and the bad’ of CRP in multiple settings in LMICs. In brief, the literature that was reviewed suggests that CRP testing may be beneficial in low-resource settings to improve rational antibiotic use for febrile patients, but the positive predictive value is insufficient to allow it to be used alone as a single tool. CRP testing may be best used as part of a panel of diagnostic tests and algorithms. Further studies in low-resource settings, particularly with regard to impact on antibiotic prescribing and cost-effectiveness of CRP testing, are warranted.

Diagnosis of neonatal sepsis in low resource settings: C-reactive protein or procalcitonin?

2016 ◽  
Vol 03 (02) ◽  
pp. 079-083
Author(s):  
Lawrence Mbuagbaw ◽  
Francisca Monebenimp ◽  
Bolaji Obadeyi ◽  
Grace Bissohong ◽  
Marie-Thérèse Obama ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein

scholarly journals Siphon-Controlled Automation on a Lab-on-a-Disc Using Event-Triggered Dissolvable Film Valves

Biosensors ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 73
Author(s):  
Brian D. Henderson ◽  
David J. Kinahan ◽  
Jeanne Rio ◽  
Rohit Mishra ◽  
Damien King ◽  
...  
Keyword(s):  
Risk Factor ◽  
Limit Of Detection ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein ◽  
Limit Of Quantitation ◽  
Chemiluminescent Immunoassay ◽  
Event Triggered

Within microfluidic technologies, the centrifugal microfluidic “Lab-on-a-Disc” (LoaD) platform offers great potential for use at the PoC and in low-resource settings due to its robustness and the ability to port and miniaturize ‘wet bench’ laboratory protocols. We present the combination of ‘event-triggered dissolvable film valves’ with a centrifugo-pneumatic siphon structure to enable control and timing, through changes in disc spin-speed, of the release and incubations of eight samples/reagents/wash buffers. Based on these microfluidic techniques, we integrated and automated a chemiluminescent immunoassay for detection of the CVD risk factor marker C-reactive protein displaying a limit of detection (LOD) of 44.87 ng mL−1 and limit of quantitation (LoQ) of 135.87 ng mL−1.

scholarly journals Preserved C-reactive protein responses to blood stream infections following tocilizumab treatment for COVID-19

2021 ◽  
Author(s):  
Emmanuel Q Wey ◽  
Clare Bristow ◽  
Aarti Nandani ◽  
Bryan O'Farrell ◽  
Jay Pang ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Bacterial Infections ◽  
Blood Stream ◽  
Antibiotic Prescribing ◽  
C Reactive Protein ◽  
Blood Stream Infections ◽  
Reactive Protein

C-reactive protein (CRP) levels are elevated following bacterial infections but may be attenuated by the IL-6-receptor antagonist tocilizumab. In hospitalised COVID-19 patients, tocilizumab induced a transient (<21 day) fall in CRP but retained CRP responses to nosocomial blood stream infections, and therefore its utility in guiding antibiotic prescribing.

scholarly journals Optimizing integrated imaging service delivery by tier in low-resource health systems

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kristen DeStigter ◽  
Kara-Lee Pool ◽  
Abimbola Leslie ◽  
Sarwat Hussain ◽  
Bien Soo Tan ◽  
...  
Keyword(s):  
Service Delivery ◽  
Health System ◽  
Low Income ◽  
Care Delivery ◽  
Scale Up ◽  
Health Coverage ◽  
Low Resource Settings ◽  
Low Resource ◽  
Low Middle Income Countries ◽  
Budgetary Decisions

AbstractAccess to imaging diagnostics has been shown to result in accurate treatment, management, and optimal outcomes. Particularly in low-income and low-middle-income countries (LICs, LMICs), access is limited due to a lack of adequate resources. To achieve Sustainable Development Goal (SDG) 3, access to imaging services is critical at every tier of the health system. Optimizing imaging services in low-resource settings is best accomplished by prescriptive, integrated, and coordinated tiered service delivery that takes contextual factors into consideration. To our knowledge, this is the first recommendation for optimized, specific imaging care delivery by tier. A model for tier-based essential imaging services informs and guides policymakers as they set priorities and make budgetary decisions. In this paper, we recommend a framework for tiered imaging services essential to reduce the global burden of disease and attain universal health coverage (UHC). A lack of access to basic imaging services, even at the lowest tier of the health system, can no longer be justified by cost. Worldwide, affordable modalities of modern ultrasound and X-ray are becoming an accessible mainstay for the investigation of common conditions such as pregnancy, pneumonia, and fractures, and are safely performed and interpreted by qualified professionals. Finally, given the vast gap in access to imaging resources between LMICs and high-income countries (HICs), a scale-up of tiered imaging services in low-resource settings has the potential to reduce health disparities between, and within countries. As the access to appropriately integrated imaging services improves, UHC may be achieved.

scholarly journals Digitally-enabled approach to improving primary care in a rural and remote low-resource setting

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Ansell
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Low Income ◽  
Digital Health ◽  
Health Priorities ◽  
Rural And Remote ◽  
Low Resource Settings ◽  
Digital Platform ◽  
Low Resource ◽  
Out Of Pocket Payments

Abstract Introduction An innovative digitally-supported multi-sectoral solution for supporting end-to-end primary care for rural and remote low-income populations in Western Visayas, Philippines was examined to determine its efficacy in supporting health access. This solution brings together multisectoral stakeholders using a digital platform to coordinate the provision of a virtual primary care system. The solution also supports ordering and delivery of low-cost insurance and medicines, with the aim of reducing out-of-pocket payments and complementing public-sector services. Methods Processes and outputs for a novel data-driven digital health solution were documented and analyzed through a mixed methods approach. Researchers conducted interviews with a range of stakeholders, including program beneficiaries and partners. Quantitative data focusing on the project outputs were also examined. Results Through an integrated digital platform to coordinate inputs from the public sector (Department of Health); private sector (pharmaceutical, insurance, and telecom firms); and community (in the form of a peer-worker network), this model offers an example of an innovative approach to primary health delivery in low-resource settings. These inputs are leveraged and informed by a 'big-data' precision approach, based on detailed epidemiological profiles of community residents. This dataset allows for the evidence-based identification of village-specific health priorities and development of corresponding interventions. This approach has contributed to increased access to medicines; affordability of medicines and health services; and community resilience among the target populations. However, barriers involving a local shortage of health human resources and cumbersome eHealth regulations affect program impact. Conclusions This research provides evidence for the scale-up of a multisectoral digital approach to support the implementation of UHC targets in Philippines. Key messages Implementing digital health solutions in low-resource settings is possible. Changes are needed in Philippines health regulations for digital health to properly support UHC implementation.

Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections

2005 ◽  
Vol 24 (4) ◽  
pp. 272-275 ◽  
Author(s):  
G. L. Petrikkos ◽  
S. A. Christofilopoulou ◽  
N. K. Tentolouris ◽  
E. A. Charvalos ◽  
C. J. Kosmidis ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
C Reactive Protein ◽  
Reactive Protein

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

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