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Background. We compared the results of a serum-based measles immunoglobulin M (IgM) test with results of tests using paired reconstituted dried filter paper blood spot (DBS) samples to assess the feasibility of using DBS samples for measles diagnostic procedures. Methods. We collected 588 paired serum and DBS samples from 349 children aged 8 months through 12 years at Mulago Hospital in Kampala, Uganda; of these samples, 513 (87%) were collected from children with a clinical diagnosis of measles 0-33 days after rash, and 75(13%) were collected from children hospitalized for other reasons. Eluted DBS and serum samples were tested using a commercial measles IgM enzyme immunoassay. Detection of viral RNA was attempted on a subset of 20 DBS by reverse-transcriptase polymerase chain reaction. Results. Among the 513 sample pairs collected from children with measles, the concordances for samples collected during days 0-6 and >1 week after rash were 95.7% and 100%, respectively (P < .01). The relative sensitivity and specificity of the DBS-based assay during the first week were 98.7%and 88.9%, respectively, and the sensitivity and specificity >1 week after rash were 100% and 100%, respectively. Viral RNA was detected in 5 (26%) of 19 DBS samples tested. Among 75 sample pairs collected fromchildren hospitalized for other reasons, concordance was 94.7%. Conclusions. DBS samples are a feasible alternative sample for measles diagnostic procedures in high-incidence settings. [ABSTRACT FROM AUTHOR]

Patient-centered care is a central pillar of the World Health Organization’s End TB Strategy. Understanding where patients access health services is a first step to planning for the placement of services to meet patient needs and preferences. The patient-pathway analysis (PPA) methodology detailed in this article was developed to better understand the alignment between patient care seeking and tuberculosis service availability. A PPA describes the steps that people with tuberculosis take from the initial care visit to cure. The results of a PPA reveal programmatic gaps in care seeking, diagnosis, treatment initiation, and continuity of care. They can be used as inputs to an evidence-based process of identifying and developing interventions to address the gaps in patient care. This paper summarizes the steps to conduct a PPA and serves as the basis for understanding country case studies that profile the use of PPA. [ABSTRACT FROM AUTHOR]

Investigates challenges and strategies for laboratory diagnosis of measles in an international setting. Characteristics of an ideal specimen collection method; Assessment of the utilities of oral fluid and filter paper collection methods in supporting measles diagnosis and strain surveillance.

An editorial is presented on the use of sputum microscopy for the analysis if mycobacterium tuberculosis infections, focusing on the paper by Datta and colleagues within the issue of "The Journal of Infectious Diseases," on mycobacterial counts. It demonstrates that close contacts of patients with higher percentage of fluorescein diacetate microscopy-negative cells are significantly at risk of developing tuberculosis.