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Point-of-Care Appro...
Point-of-Care Approaches for Meningitis Diagnosis in a Low-Resource Setting (Southwestern Uganda) : Observational Cohort Study Protocol of the "PI-POC" Trial
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- Gaudenzi, Giulia (författare)
- Karolinska Institutet,KTH,Nanobioteknologi,Science for Life Laboratory, SciLifeLab,Karolinska Inst, Dept Global Publ Hlth, Tomtebodavagen 18 A, S-17177 Stockholm, Sweden.
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- Kumbakumba, Elias (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.
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- Rasti, Reza (författare)
- Karolinska Institutet
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- Nanjebe, Deborah (författare)
- MSF Epictr Mbarara Res Ctr, Mbarara, Uganda.
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- Reu, Pedro (författare)
- KTH,Affinitets-proteomik,Science for Life Laboratory, SciLifeLab
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- Nyehangane, Dan (författare)
- MSF Epictr Mbarara Res Ctr, Mbarara, Uganda.
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- Mårtensson, Andreas, 1963- (författare)
- Uppsala universitet,Internationell barnhälsa och nutrition
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- Nassejje, Milly (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.
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- Karlsson, Jens (författare)
- Karolinska Institutet
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- Mzee, John (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.;Holy Innocents Childrens Hosp, Mbarara, Uganda.
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- Nilsson, Peter (författare)
- KTH,Science for Life Laboratory, SciLifeLab,Affinitets-proteomik
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- Businge, Stephen (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.;Holy Innocents Childrens Hosp, Mbarara, Uganda.
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- Loh, Edmund (författare)
- Karolinska Institutet
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- Boum, Yap, II (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.;MSF Epictr Mbarara Res Ctr, Mbarara, Uganda.
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- Svahn Andersson, Helene (författare)
- KTH,Science for Life Laboratory, SciLifeLab,Nanobioteknologi
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- Gantelius, Jesper (författare)
- KTH,Nanobioteknologi,Science for Life Laboratory, SciLifeLab
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- Mwanga-Amumpaire, Juliet (författare)
- Mbarara Univ Sci & Technol, Fac Med, Dept Paediat & Child Hlth, Mbarara, Uganda.;MSF Epictr Mbarara Res Ctr, Mbarara, Uganda.
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- Alfven, Tobias (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2020-11-04
- 2020
- Engelska.
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 22:11
- Relaterad länk:
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https://doi.org/10.2...
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https://www.research...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.2...
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http://kipublication...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Background: A timely differential diagnostic is essential to identify the etiology of central nervous system (CNS) infections in children, in order to facilitate targeted treatment, manage patients, and improve clinical outcome. Objective: The Pediatric Infection-Point-of-Care (PI-POC) trial is investigating novel methods to improve and strengthen the differential diagnostics of suspected childhood CNS infections in low-income health systems such as those in Southwestern Uganda. This will be achieved by evaluating (1) a novel DNA-based diagnostic assay for CNS infections, (2) a commercially available multiplex PCR-based meningitis/encephalitis (ME) panel for clinical use in a facility-limited laboratory setting, (3) proteomics profiling of blood from children with severe CNS infection as compared to outpatient controls with fever yet not severely ill, and (4) Myxovirus resistance protein A (MxA) as a biomarker in blood for viral CNS infection. Further changes in the etiology of childhood CNS infections after the introduction of the pneumococcal conjugate vaccine against Streptococcus pneumoniae will be investigated. In addition, the carriage and invasive rate of Neisseria meningitidis will be recorded and serotyped, and the expression of its major virulence factor (polysaccharide capsule) will be investigated. Methods: The PI-POC trial is a prospective observational study of children including newborns up to 12 years of age with clinical features of CNS infection, and age-/sex-matched outpatient controls with fever yet not severely ill. Participants are recruited at 2 Pediatric clinics in Mbarara, Uganda. Cerebrospinal fluid (for cases only), blood, and nasopharyngeal (NP) swabs (for both cases and controls) sampled at both clinics are analyzed at the Epicentre Research Laboratory through gold-standard methods for CNS infection diagnosis (microscopy, biochemistry, and culture) and a commercially available ME panel for multiplex PCR analyses of the cerebrospinal fluid. An additional blood sample from cases is collected on day 3 after admission. After initial clinical analyses in Mbarara, samples will be transported to Stockholm, Sweden for (1) validation analyses of a novel nucleic acid-based POC test, (2) biomarker research, and (3) serotyping and molecular characterization of S. pneumoniae and N. meningitidis. Results: A pilot study was performed from January to April 2019. The PI-POC trial enrollment of patients begun in April 2019 and will continue until September 2020, to include up to 300 cases and controls. Preliminary results from the PI-POC study are expected by the end of 2020. Conclusions: The findings from the PI-POC study can potentially facilitate rapid etiological diagnosis of CNS infections in low-resource settings and allow for novel methods for determination of the severity of CNS infection in such environment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- global health
- central nervous system infections
- pediatrics
- diagnostics
- low-resource settings
- meningitis
- Uganda
- children
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Gaudenzi, Giulia
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Kumbakumba, Elia ...
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Rasti, Reza
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Nanjebe, Deborah
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Reu, Pedro
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Nyehangane, Dan
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visa fler...
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Mårtensson, Andr ...
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Nassejje, Milly
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Karlsson, Jens
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Mzee, John
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Nilsson, Peter
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Businge, Stephen
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Loh, Edmund
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Boum, Yap, II
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Svahn Andersson, ...
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Gantelius, Jespe ...
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Mwanga-Amumpaire ...
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Alfven, Tobias
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Folkhälsovetensk ...
- Artiklar i publikationen
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Journal of Medic ...
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JMIR Research Pr ...
- Av lärosätet
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Kungliga Tekniska Högskolan
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Karolinska Institutet
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Uppsala universitet