Assessing Asymptomatic Malaria Carriage of Plasmodium falciparum and Non-falciparum Species in Children Resident in Nkolbisson, Yaoundé, Cameroon

Malaria is still a threat to public health as it remains the first endemic disease in the world. It is a pervasive parasitic disease in tropical and subtropical regions where asymptomatic malaria infection among humans serves as a significant reservoir for transmission. A rapid and correct diagnosis is considered to be an important strategy in the control of the disease especially in children, who are the most vulnerable group. This study assessed the prevalence of asymptomatic malaria in children at the Nkolbisson health area in Yaoundé, Cameroon. A cross-sectional study design and a convenience sampling plan were used. A total of 127 participants were recruited after informed and signed consent from parents and/or guardians. Blood samples were collected by finger-pricking and venipuncture from children aged 6 months to 10 years and then screened for asymptomatic parasitemia by a rapid diagnostic test (RDT), light microscopy (LM) staining with Giemsa and 18S rRNA polymerase chain reaction (PCR) for speciation. The data were analyzed using SPSS version 20 software. The study identified 85 children who were positive from the PCR, 95 positive from the RDT and 71 from the LM, revealing a malaria prevalence of 66.9%, 74.8% and 55.9%, respectively. The prevalence was not observed to be dependent on the sex and age group of the participants. Plasmodium falciparum was the predominant species followed by Plasmodium malariae and then Plasmodium ovale. The RDT and LM had the same sensitivity (90.6%) with a slight difference in their specificity (RDT: 57.1%; LM: 54.8%). The RDT also demonstrated higher positive and negative predictive values compared with those of the LM.

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Plasmodium falciparum DHFR and DHPS Mutations Are Associated With HIV-1 Co-Infection and a Novel DHPS Mutation I504T Is Identified in Western Kenya

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.600112 ◽

2020 ◽

Vol 10 ◽

Author(s):

Brandi K. Torrevillas ◽

Sarah M. Garrison ◽

Alexander J. McKeeken ◽

Dharmeshkumar Patel ◽

James T. Van Leuven ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Haplotype Diversity ◽

Plasmodium Malariae ◽

Drug Binding ◽

Cross Resistance ◽

Asymptomatic Malaria ◽

Newly Diagnosed ◽

Cross Sectional ◽

Antifolate Resistance ◽

Hiv 1

Antifolate resistance is significant in Kenya and presumed to result from extensive use and cross-resistance between antifolate antimalarials and antibiotics, including cotrimoxazole/Bactrim used for HIV-1 chemotherapy. However, little is known about antifolate-resistant malaria in the context of newly diagnosed HIV-1 co-infection prior to administration of HIV-1 chemotherapy. Blood samples from a cross-sectional study of asymptomatic adult Kenyans enrolled during voluntary HIV testing were analyzed by PCR for Plasmodium spp. More than 95% of volunteers with identifiable parasite species (132 HIV-1 co-infected) were infected with Plasmodium falciparum alone or P. falciparum with Plasmodium ovale and/or Plasmodium malariae. Deep sequencing was used to screen for mutations in P. falciparum dihydrofolate reductase (dhfr) (N51I, C59R, S108N, I164L) and dihydropteroate synthase (dhps) (S436H, A437G, K540E, A581G) from 1133 volunteers. Individual mutations in DHPS but not DHFR correlated with HIV-1 status. DHFR haplotype diversity was significantly different among volunteers by gender and HIV-1 status. DHPS haplotype diversity by HIV-1 status was significantly different between volunteers paired by age and gender, indicating that patterns of resistance were independent of these variables. Molecular simulations for a novel DHPS mutation (I504T) suggested that the mutated protein has increased affinity for the endogenous ligand DHPPP and decreased affinity for drug binding. A sub-group of monoclonal infections revealed that age and parasitemia were not correlated and enabled identification of a rare septuple-mutant haplotype (IRNL-HGEA). In our study, adult Kenyans newly diagnosed with HIV-1 infection were predominantly infected with moderately resistant P. falciparum, with patterns of infecting parasite genotypes significantly associated with HIV-1 status. Together with the discovery of DHPS I504T, these data indicate that antifolate resistance continues to evolve in Kenya. Further, they highlight the need to understand the effects of associated mutations on both fitness and resistance of P. falciparum in the context of HIV-1 co-infection to better inform treatment for asymptomatic malaria.

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Detecting Plasmodium falciparum in community surveys: a comparison of Paracheck Pf® Test and ICT Malaria Pf® Cassette Test to polymerase chain reaction in Mutasa District, Zimbabwe

Malaria Journal ◽

10.1186/s12936-020-03536-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Nobert Mudare ◽

Zvifadzo Matsena-Zingoni ◽

Aramu Makuwaza ◽

Edmore Mamini ◽

Shungu S. Munyati ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Plasmodium Falciparum ◽

Mitochondrial Gene ◽

Dried Blood Spots ◽

Diagnostic Methods ◽

Chain Reaction ◽

Cross Sectional ◽

Predictive Values ◽

Polymerase Chain ◽

Pcr Targeting

Abstract Background Microscopy and rapid diagnostic tests (RDTs) are the main techniques used to diagnose malaria. While microscopy is considered the gold standard, RDTs have established popularity as they allow for rapid diagnosis with minimal technical skills. This study aimed to compare the diagnostic performance of two Plasmodium falciparum histidine-rich protein 2 (PfHRP2)-based RDTs (Paracheck Pf® Test (Paracheck) and Malaria Pf™ ICT (ICT)) to polymerase chain reaction (PCR) in a community survey. Methods A cross-sectional study was conducted between October 2012 and December 2014 in Mutasa District, Manicaland Province, eastern Zimbabwe. Households were randomly selected using satellite imagery, and 224 households were visited. Residents present in the household on the date of the visit were recruited for the study. Participants of all age groups from the selected households were screened with Paracheck and ICT RDTs in parallel. Dried blood spots (DBS) and thin and thick smears were collected. Parasite DNA extracted from the DBS was subjected to nested PCR targeting the Plasmodium cytochrome b mitochondrial gene. Data analysis was performed using the Cohen’s Kappa test to determine the interrater agreement and the sensitivity and specificity of the diagnostic test were reported. Results Results from a total of 702 participants were analysed. Most were females, 397 (57%), and the median age of participants was 21 years with an interquartile range of 9–39 years. Of those who were screened, 8 (1.1%), 35 (5.0%), and 21 (2.9%) were malaria parasite positive by microscopy, RDT and PCR, respectively. Paracheck and ICT RDTs had a 100% agreement. Comparing RDT and PCR results, 34 participants (4.8%) had discordant results. Most of the discordant cases were RDT positive but PCR negative (n = 24). Half of those RDT positive, but PCR negative individuals reported anti-malarials to use in the past month, which is significantly higher than reported anti-malarial drug use in the population (p < 0.001). The participant was febrile on the day of the visit, but relying on PfHRP2-based RDT would miss this case. Among the diagnostic methods evaluated, with reference to PCR, the sensitivity was higher with the RDT (52.4%) while specificity was higher with the microscopy (99.9%). The positive predictive value (PPV) was higher with the microscopy (87.5%), while the negative predictive values were similar for both microscopy and RDTs (98%). Overall, a strong correlated agreement with PCR was observed for the microscopy (97.9%) and the RDTs (95.2%). Conclusions Paracheck and ICT RDTs showed 100% agreement and can be used interchangeably. As malaria transmission declines and Zimbabwe aims to reach malaria elimination, management of infected individuals with low parasitaemia as well as non-P. falciparum infection can be critical.

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Assessment of Demographic Factors Associated with Falciparum Malaria among Hospital Patients in Zaria, Kaduna State Nigeria

South Asian Journal of Research in Microbiology ◽

10.9734/sajrm/2019/v5i330129 ◽

2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Gideon Yakusak Benjamin ◽

Benjamin Bartholomew ◽

Jabir Abdullahi ◽

Liman, Mubarak Labaran

Keyword(s):

Plasmodium Falciparum ◽

Falciparum Malaria ◽

Demographic Data ◽

Age Groups ◽

Demographic Factors ◽

Cross Sectional Study ◽

Malaria Prevalence ◽

Cross Sectional ◽

Factors Associated ◽

Hospital Patients

Aim: Malaria is a mosquito-borne disease caused by parasites that belong to the genus Plasmodium. It is responsible for the death of millions of people worldwide. This study was aimed at assessing some demographic factors associated with falciparum malaria among hospital patients in Zaria, Kaduna State Nigeria. Methods: A cross sectional study was carried out involving three hundred consenting participants. A structured questionnaire was used to obtain demographic data from the participants; blood samples were collected from them and screened for Plasmodium falciparum by Rapid Diagnostic Test. Giemsa stained thick and thin blood films were prepared and examined under the microscope to confirm the presence of the parasite. The data obtained were analyzed and P values ≤0.05 were considered statistically significant. Results: The prevalence of malaria in males [22.6%] was slightly higher than females [21.7%]. The age group ≤10 had the highest prevalence followed by age groups 31-40 [31%], 11-20 [23.3%], 21-30 [12.6%] and ≥41 [9.1%] [p=0.002]. Participants who were married had higher prevalence [31.1%] than those who were divorced [0.0%] and single [13.2%] [p=0.000]. Conclusion: The research shows that Plasmodium falciparum is still prevalent in the study area. Age and marital status are important determinants of malaria prevalence as highlighted in this study. Children less than 10 years are at high risk for malaria, preventive measures should therefore target this group.

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High prevalence of asymptomatic Plasmodium infection in Bandafassi, South-East Senegal

Malaria Journal ◽

10.1186/s12936-021-03746-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Aida Sadikh Badiane ◽

Tolla Ndiaye ◽

Alphonse Birane Thiaw ◽

Deme Awa Binta ◽

Mamadou Alpha Diallo ◽

...

Keyword(s):

Malaria Control ◽

Control Strategies ◽

Single Species ◽

Plasmodium Malariae ◽

Cross Sectional Study ◽

Malaria Prevalence ◽

Cross Sectional ◽

Malaria Transmission Season ◽

Photo Induced Electron Transfer ◽

Asymptomatic Individuals

Abstract Background Malaria control and elimination strategies are based on levels of transmission that are usually determined by data collected from health facilities. In endemic areas, asymptomatic Plasmodium infection is thought to represent the majority of infections, though they are not diagnosed nor treated. Therefore, there might be an underestimation of the malaria reservoir, resulting in inadequate control strategies. In addition, these untreated asymptomatic Plasmodium infections maintain transmission, making it difficult or impossible to reach malaria elimination goals. Thus, the aim of this study was to determine the prevalence of asymptomatic Plasmodium infections in southeastern Senegal. Methods A cross sectional study was conducted among asymptomatic individuals (N = 122) living in the village of Andiel located in Bandafassi, Kédougou, which consisted of about 200 inhabitants during the malaria transmission season in late October 2019. For each individual without malaria-related symptoms and who consented to participate, a rapid diagnostic test (RDT) was performed in the field. Results were confirmed in the laboratory with photo-induced electron transfer (PET-PCR). Results Malaria prevalence was 70.3% by PET-PCR and 41.8% by RDT. During the same period, the health post of the area reported 49. 1% test positivity rate by RDT. The majority of the infected study population, 92.9%, was infected with a single species and 7.1% had two or three species of Plasmodium. Plasmodium falciparum was predominant and represented 90.2% of the infections, while 6.5% were due to Plasmodium ovale and 3.3% to Plasmodium malariae. 59.4% of children targeted for SMC (zero to ten years old) were infected. Conclusion In southeastern Senegal, where the transmission is the highest, malaria control strategies should address asymptomatic Plasmodium infections at the community level. The results suggest that this area could be eligible for mass drug administration. Moreover, non-falciparum species could be more common and its prevalence should be determined countrywide.

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Epidemiological trends of malaria in the Western regions of Saudi Arabia: a cross sectional study

The Journal of Infection in Developing Countries ◽

10.3855/jidc.13246 ◽

2020 ◽

Vol 14 (11) ◽

pp. 1332-1337

Author(s):

Omar SO Amer ◽

Mohamed I Waly ◽

Izhar W Burhan ◽

Esam S Al-Malki ◽

Amor Smida ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Saudi Arabia ◽

Malaria Infection ◽

Plasmodium Malariae ◽

Cross Sectional Study ◽

Age Group ◽

Cross Sectional ◽

The Mean ◽

Almost All ◽

Epidemiological Trends

Introduction: Saudi Arabia has successfully reduced malaria cases to be constrained largely in the western regions. This study aimed to determine the epidemiological trends of malaria infection in five western regions of Saudi Arabia. Methodology: A retrospective analysis was conducted to investigate the epidemiological trends of malaria infection in the western regions, based on the published registry of the Saudi Ministry of Health, during the period from 2014 to 2017 using the appropriate statistical tools. Results: A total of 8925 confirmed cases of malaria were reported in the western regions during the period from 2014 to 2017 with the mean of 2231 malaria cases per year. The minimum (n = 1097) and maximum (n = 4075) number of cases were reported in 2014 and 2016 respectively. The highest (n = 5919, 66.3%) number of cases were reported from Jazan region, while lowest (n = 86, 1.0%) number of cases were reported from Al-Bahah region. Plasmodium falciparum was the most frequently reported species with 7485 (83.9%) cases, while Plasmodium vivax accounted 1386 (15.5%) cases. Plasmodium malariae and mixed infections were insignificant and accounted 0.5% (n = 48) and 0.1% (n = 6) cases respectively. In relation to malaria infection and age group, malaria was predominant in > 15 age group. The highest number of malaria cases in almost all years was observed from January until March and the lowest number was reported from May until July. Conclusions: Plasmodium falciparum was the most dominant species in this survey and Jazan was the most affected region.

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Bayesian evaluation of the performance of three diagnostic tests for Plasmodium falciparum infection in a low-transmission setting in Kilifi County, Kenya

Wellcome Open Research ◽

10.12688/wellcomeopenres.15204.1 ◽

2019 ◽

Vol 4 ◽

pp. 67

Author(s):

Marshal M. Mweu ◽

Juliana Wambua ◽

Fixtan Njuga ◽

Philip Bejon ◽

Daniel Mwanga

Keyword(s):

Plasmodium Falciparum ◽

Diagnostic Tests ◽

Latent Class ◽

Clinical Care ◽

Latent Class Model ◽

Asymptomatic Malaria ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Predictive Values ◽

Primary Health Care Settings

Background: Central to the successful elimination of Plasmodium falciparum malaria, are tests with superior capability of diagnosing low-density parasitaemias. Empirical evidence on the performance of the commonly available diagnostics (light microscopy (LM), rapid diagnostic tests (RDT) and polymerase chain reaction (PCR)) is needed to better inform case management and surveillance activities within primary health care settings where elimination of falciparum malaria is targeted. The objective of this study was to estimate the sensitivity (Se) and specificity (Sp) and predictive values of LM, RDT and PCR tests for P. falciparum infection, while evaluating the effect of specific covariates on the accuracy of the tests. Methods: The study enrolled 1,563 children via a cross-sectional survey for asymptomatic malaria and those presenting with symptomatic malaria to the Ngerenya dispensary, Kilifi County between March and December 2014. A Bayesian latent class model (BLCM) was fitted to the participants’ diagnostic data obtained from blood samples that were screened for the presence of P. falciparum using the three tests. Results: The PCR assay registered a higher Se (97.6% [92.0; 99.7]) than LM (84.0% [74.8; 91.0]) but similar to RDT (92.2% [84.4; 97.0]). However, the assay showed a similar Sp (98.9% [98.2; 99.4]) to both RDT (99.4% [98.9; 99.7]) and LM (99.5% [99.0; 99.8]). Regarding predictive values, the tests yielded statistically similar estimates of Positive and negative predictive values (PPV and NPV). A serial interpretation of the results of RDT and LM raised the PPVs and NPVs to >98%. Conclusions: LM and RDT tests afford high Se and Sp in a low P. falciparum prevalence setting. A serial combination of the tests assures high PPV and NPV estimates. These elements, coupled with the wide deployment and affordability of the tests, lend the tests useful for guiding clinical care and surveillance activities for P. falciparum within elimination settings.

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The Prevalence of Insecticide Treated Net/malaria :cross section study (Preprint)

10.2196/preprints.16825 ◽

2019 ◽

Author(s):

Chanda Chalela

Keyword(s):

Study Design ◽

Age Groups ◽

Cross Sectional Study ◽

Malaria Prevalence ◽

Malaria Patient ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Itn Use ◽

Structured Questionnaire

BACKGROUND ABSTRACT Introduction a study on prevalence of ITN use was carried out in Buchi community Kitwe Zambia from August to October 2019 OBJECTIVE Prevalence of ITN in BUchi METHODS Methodology: This was a cross sectional study design. A structured questionnaire was used to ascertain ownership and utilization and oral interviews, 200 households were targeted 844 individual covered across the 200 households. Data was analyzed with SPSS version 23. RESULTS ABSTRACT Introduction a study on prevalence of ITN use was carried out in Buchi community Kitwe Zambia from August to October 2019 Methodology: This was a cross sectional study design. A structured questionnaire was used to ascertain ownership and utilization and oral interviews, 200 households were targeted 844 individual covered across the 200 households. Data was analyzed with SPSS version 23. Findings: household ownership of at least an ITN was 52% and individual utilization at 37.6%, with 0.825 ITN/households and 0.195ITN /individual. Malaria prevalence of 52.4% /household and a 12.4% of the population. With 47.6% malaria patient coming from households with ITN and 60% of households with ITN have insufficient coverage.61% of malaria patient were female and 31 % male. however there was no significant relation between Gender and malaria prevalence in study area (p value was >0.05). Malaria cases distribution with age groups, 0-15yrs old represented 49.5%, 16-30 yrs., was at 27.6% and the over 30 yrs. case were at 22.9% .use of other preventive measures 23% used mosquito repellent ,others methods 1% with those not using any other methods 76%. CONCLUSIONS Conclusion The study showed clearly that malaria still poses a problem .the prevalence rate of malaria was still high 12.4% of the population and 52.4% of households. With high prevalence of malaria of 49.5% for 0-15yrs.the difference between ownership 52% and Utilization 37.6% showed that even household with ITN, the ITN were not sufficient.60% of households with ITN, the ITN were not sufficient for all occupants

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425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.619 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S279-S279

Author(s):

Eimear Kitt ◽

Julia S Sammons ◽

Kathleen Chiotos ◽

Susan E Coffin ◽

...

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Diagnostic Testing ◽

Cross Sectional Study ◽

Upper Respiratory Tract ◽

Cross Sectional ◽

Mechanically Ventilated ◽

Paired Samples ◽

Control And Prevention ◽

Polymerase Chain

Abstract Background The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. Methods Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. Results 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Figure 1. Performance of upper and lower respiratory tract SARS-CoV-2 PCR testing in children with artificial airways Conclusion Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. Disclosures All Authors: No reported disclosures

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G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

Tropical Medicine and Health ◽

10.1186/s41182-021-00339-7 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Kay Thwe Han ◽

Zay Yar Han ◽

Kyin Hla Aye ◽

Khin Thet Wai ◽

Aung Thi ◽

...

Keyword(s):

Enzyme Activity ◽

Malaria Elimination ◽

G6pd Deficiency ◽

Control Program ◽

Cross Sectional Study ◽

Diagnostic Tools ◽

Asymptomatic Malaria ◽

Radical Cure ◽

Readiness Assessment ◽

Cross Sectional

Abstract Background Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies. Methods A cross-sectional study in one township each with high malaria burden from two states in the western part of Myanmar, was conducted during 2016-2018, and 320 participants (164 Rakhine and 156 Chin National groups) were recruited. We used RDT and ultrasensitive polymerase chain reaction (us PCR) method to confirm malaria infection, and a G6PD RDT(CareStart) to detect G6PDd and PCR/restriction fragment length polymorphism (RFLP) method to confirm the variant of G6PDd for genotyping. G6PD enzyme activity was measured by G6PD Biosensor (CareStart). Results Malaria positivity rates detected by RDT were lower than those detected by us PCR in the combined samples [13% (42/320) vs. 21% (67/320)] as well as in the Rakhine samples [17% (28/164) vs. 25% (41/164)] and in Chin samples [9% (14/156) vs. 17% (26/156)]. G6PD deficiency rates were approximately 10% in both the combined samples and specific national groups. For G6PD enzyme activity in the combined samples, G6PDd (defined as < 30% of adjusted male median) was 10% (31/320) and severe G6PDd (< 10% of AMM) was 3% (9/320). Among malaria-infected patients with positive by both RDT and usPCR, G6PDd was less than 20% in each national group. G6PD genotyping showed that the G6PD Mahidol (G487A) was the major variant. Conclusions The varying degree of G6PDd detected among malaria-infected national groups by advanced diagnostic tools, strongly support the recommend G6PD testing by the National Malaria Control Program and the subsequent safe treatment of P. vivax by primaquine for radical cure. Establishing a field monitoring system to achieve timely malaria elimination is mandatory to observe the safety of patients after PQ treatment.

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West Nile Virus Chorioretinitis in the Presence of Negative Cerebrospinal Fluid Polymerase Chain Reaction Results

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420979254 ◽

2021 ◽

pp. 247412642097925

Author(s):

Kareem Moussa ◽

Karen W. Jeng-Miller ◽

Leo A. Kim ◽

Dean Eliott

Keyword(s):

Cerebrospinal Fluid ◽

West Nile Virus ◽

Cross Sectional Study ◽

Nucleic Acid Amplification ◽

Sectional Study ◽

Chain Reaction ◽

West Nile ◽

Cross Sectional ◽

Positive Serum ◽

Polymerase Chain

Purpose: This work aims to evaluate the utility of nucleic acid amplification testing (NAAT) and serology in confirming West Nile Virus (WNV) infection in patients with suspected WNV chorioretinitis. Methods: A retrospective cross-sectional study was conducted of a cluster of patients who presented to the Retina Service of Massachusetts Eye and Ear between September and October 2018. Results: Three patients were identified with classic WNV chorioretinitis lesions with negative cerebrospinal fluid NAAT and positive serum serology findings. The diagnosis of WNV chorioretinitis was made based on the appearance of the fundus lesions and the presence of characteristic findings on fluorescein angiography as previously described in the literature. Conclusions: This report highlights 3 unique cases of WNV chorioretinitis in which NAAT of cerebrospinal fluid failed to identify WNV as the inciting agent. These cases stress the importance of serum serologic testing in diagnosing WNV infection.

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