Search

BACKGROUND AND OBJECTIVES: Discrepancy between forward and reverse ABO grouping could be due to several reasons including genetic mutations of the alleles encoding group specific transferase. The healthy donors found with weak A antigen were investigated to ascertain the allele responsible for variation. MATERIALS AND METHODS: Standard serological methods were employed using commercial antisera. The molecular sequencing was performed on DNA with enrichment library prep kit and a custom designed overlapping probe panel. Binary alignment mapping files, generated on board the Illumina MiSeq instrument and aligned to the GRCh37/Hg19 reference genome, were uploaded to the QIAGEN CLC genomics workbench software (version. 20) where variant call files were generated and analyzed. RESULTS: Red blood cells (RBCs) of six healthy donors, showing weak mix-field agglutination by anti-A and anti-A, B and plasma with absence or weakly reacting anti-A, were investigated serologically. The RBCs incubated with anti-A yield positive elution and their saliva lacked A but possessed H antigen thereby classifying as a historical known phenotype Aend. Family study on 4 probands showed inheritance of the trait. Molecular studies revealed presence of ABO*A allele carrying rare novel variant referred to as c.106delinsGG in line with HGVS recommendation that was thought to be responsible for the variant of A. CONCLUSION: Six cases serologically defined as A were found to be associated with novel weak allele ABO*A (c.106delinsGG). The Aweak phenotype with the novel allele has not been displayed on International Society of Blood Transfusion database, though c.106delinsGG is listed in the UCSC genome browser under rs782544248. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anti-glutamate decarboxylase 65 antibody-associated cerebellar ataxia (anti-GAD65Ab-associated CA) is the most widely studied immune-mediated CA. There are few case series evaluating the clinical, radiological, treatment profile, and outcome of anti-GAD65Ab-associated CA. OBJECTIVE: To study the clinical, radiological profile, associated neoplasm, treatment outcome, and prognosis in patients diagnosed with anti-GAD65Ab-associated CA. METHODS: A retrospective descriptive analysis of a cohort of patients diagnosed with anti-GAD65Abassociated CA was performed and analyzed. RESULTS: Thirteen patients were selected for the analysis with female predominance (70%). The mean age at presentation was 47.5 ± 11.1 years (range, 29-65 years), and the median duration of the symptoms was 4 months. All 13 patients (100%) had gait ataxia. Ten patients had limb ataxia along with gait ataxia (75%). Seven patients had cerebellar dysarthria (54%). Four patients (31%) had gazeevoked jerky nystagmus. Five patients (39%) were diagnosed with type 2 diabetes mellitus, and one patient had hypothyroidism in addition to type 2 diabetes mellitus. Brain magnetic resonance imaging was normal in seven (54%) patients, and pure cerebellar atrophy was observed in six patients. One patient was detected with a colon neoplasm. All 13 patients received intravenous methylprednisolone, followed by oral steroids over 3 months. Six patients (50%) received plasma exchange along with intravenous methylprednisolone. Favorable outcomes (modified Rankin scale score =2) were observed in five patients and poor outcomes in two; six patients were lost to follow-up after the first admission. CONCLUSION: Anti-GAD65Ab-associated CA presents as subacute to chronic progressive CA with a favorable outcome with immunotherapy. Anti-GAD antibodies should be assessed in serum or cerebrospinal fluid in patients presenting subacute to chronic sporadic CA. The occurrence of a systemic neoplasm is rare in anti-GAD65Ab-associated CA. [ABSTRACT FROM AUTHOR]

Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antibodies in serum in three follow-up rounds. The overall seroprevalence increased from 73.9% in round one to 90.7% in round two and 92.9% in round three. Among seropositive rural participants in round one, 98.2% remained positive in round two, and this percentage remained stable in urban and tribal areas in round three. The results showed high antibody prevalence that increased over time and was not different based on area, age group, or sex. Vaccinated individuals had higher antibody prevalence, and nearly all participants had antibody positivity for up to six months. [ABSTRACT FROM AUTHOR]

In an ethnically diverse country like India, establishing a national rare donor registry is a massive challenge. We aimed to establish a regional rare donor registry at our center by screening the local donor population for rare phenotypes. Serological testing of O blood group donors was done using monoclonal antisera from Bio-Rad for 23 different blood group antigens, which include Rh subgroups (C,cE,e), Kell (K,k, Kpa, Kpb), P1, Duffy (Fya, Fyb), Kidd (Jka, Jkb), Lewis (Lea, Leb), Lutheran (Lua, Lub), H, M, N, S and s. We categorized the donors with rare blood phenotypes into two categories. Category-I: High-frequency antigen-negative phenotypes with a prevalence of less than 1% in our study population. Category-II: Multiple common antigen-negative phenotypes with a prevalence of less than 1% in our study population. A total of 521 donors with blood group O, meeting the inclusion criteria among a total of 23567 were phenotyped for minor blood group antigens. Out of these, 85.6% (n = 446) were Rh D positive, and 14.4% (n = 75) were Rh D negative. The male-to-female ratio was 9:1. We had identified eight rare phenotypes in category-I and 18 rare phenotypes in Category-II according to the definition adopted in our study. We have noticed a significant decrease in turnaround time in providing rare blood to patients after implementing the registry. This is a first-of-its-kind rare donor registry established in South India. Establishing a national rare donor registry is the need of the hour in India. [ABSTRACT FROM AUTHOR]

Background: Syphilis is a Sexually Transmitted Disease (STD) caused by Treponema pallidum with significant public health importance. Based on the clinical presentation syphilis is classified into primary, secondary, tertiary and latent syphilis. Lab diagnosis of syphilis can be done by serological methods using specific treponemal and non)treponemal tests. Testing strategies like traditional, reverse and European Centre for Disease Prevention and Control (ECDC) are currently used as principal diagnostic algorithms. Aim and Objectives: To compare the seropositivity among three diagnostic algorithms for syphilis serodiagnosis and data analysis using WHO NET software. Material and Methods: All the samples received for syphilis serology were tested by Rapid Plasma Reagin (RPR) and rapid immunochromatographic card methods. Three diagnostic algorithms were used. In traditional algorithm, the sample was first tested with RPR (non-treponemal test) and if reactive then interpreted as a case of syphilis. In reverse algorithm, a specific treponemal card test was done and if reactive a second non treponemal test like RPR was performed. Asecond rapid immunochromatographic test was also performed. In the case of the ECDC algorithm two specific card tests were performed and interpreted. WHO NET software was utilized for data entry and analysis. The coefficient of agreement (k value) was analyzed by using QuickCalcs GraphPad software. Results: A total of 1292 samples were tested, and 4 (0.3%) samples were reactive by traditional algorithm. By reverse and ECDC algorithm 14 (1.08%) of the samples were considered as reactive. Overall, four samples were identified as cases of definite/current syphilis and ten samples were considered as cases of probable early current / latent or treated syphilis. Reverse algorithm and ECDC algorithm detected more cases. The missed diagnosis percentage was 10 (71.42%) for traditional algorithm. Antenatal patients comprised of 334 (25.85%) samples with seropositivity of 0.29%. Maximum samples were received from the age group of 21 to 30 years 484 (37.46%). Strong degree of agreement was observed between reverse and ECDC algorithm (k value- 0.832). Conclusion: Reverse or ECDC algorithm can be implemented in the laboratory routinely to avoid missing cases of early syphilis. The specific treponemal card tests available in immunochromatography formats are easy to perform and interpret. The usage of WHO NET for analysis of data and along with including specific comments individualized for each patient in the lab reports could give valuable insight. [ABSTRACT FROM AUTHOR]

Background: Alloantibody formation to red cell antigens, sometimes seen in patients receiving multiple transfusions, are capable of causing hemolytic transfusion reactions when transfused with blood cells that are positive for the corresponding antigens. Providing them with red cells negative to these antigens becomes imperative. There is a need to have a pool of donors known to be negative for such antigens to provide blood units to such patients. Aim: The aim of the study is to identify rare donors in our population and register them for need-based blood unit collection for patients when phenotype-specific blood units are required. Methodology: Regular blood donors after consent were included for extended phenotyping for antigens c, C, e, E, K, k, Lea, Leb, Lua, Lub, P1, Kpa, Kpb, Jka, JKb, M, N, S, s, Fya, and Fyb by serological testing using monoclonal antisera. The phenotypes that were either negative for high-frequency antigens such as H, k, or multiple common antigen negative phenotypes were identified and enrolled as rare blood donors. Results: A total of 202 donors were completely phenotyped for the said 21 antigens. We identified 14 such donors, 7 of whom were high-frequency antigen-negative and 7 were multiple common antigen-negative phenotypes. The turnaround time for providing blood for patients requiring such units has drastically reduced with this initiative. A unit of such a rare phenotype was collected and shipped to Pune for a patient who required it within 24 h. Conclusion: Our findings highlight the need for a countrywide rare donor registry to coalesce the data from all centers with the facility for phenotyping. This will reduce the turnaround time of searching for donors for a particular phenotype, contributing to better patient care, and emergency management. [ABSTRACT FROM AUTHOR]

Hemorrhagic septicaemia is a fatal systemic infection associated with huge economic losses. kdling lacs of cattle and buffaloes annually in India. Serological tests have been serving for decades the fields of diagnostics and sero-epidemiology of HS in animals. The study was conducted to know the immunity status of the vaccinated buffaloes and cattle of some districts of the state of Haryana by estimation of antibody titre in 400 bovine sera samples, six months post vaccination by using monoclonal antibody-based indirect ELISA. All the animals were vaccinated either with the alum precipitated H.S. vaccine or H.S. and B.O. combined vaccine. The antibody titres were good enough four months post-vaccination. Alum precipitated vaccine gave six months immunity but it declined after four months, so this study suggested that animals should be vaccinate after every six months. [ABSTRACT FROM AUTHOR]

Background: Scianna (Sc) antigens, seven high and two of low prevalence, are expressed on erythrocyte membrane‐associated protein (ERMAP). We investigated SC (ERMAP) in individuals who made antibodies to high prevalence Scianna antigens, and propose a 3D model for ERMAP to precisely localize the residues associated with the known antigens. Methods: Serological testing and DNA sequencing was performed by standard methods. A 3D structural model was built using a multi‐template homology approach. Protein structures representing missense variants associated with the loss or gain of an antigen were generated. Residue accessibility and intraprotein interactions were compared with the wild‐type protein. Results: Two new SC alleles, one with c.349C > T (p.Arg117Cys) in a woman from South India with anti‐Sc3 in her plasma, and a c.217_219delinsTGT (p.Arg73Cys) in an African‐American woman with an antibody to a new high prevalence antigen, termed SCAC, were identified. Six structural templates were used to model ERMAP. 3D analysis showed that residues key for Scianna antigen expression were all exposed at the surface of the extracellular domain. The p.Arg117Cys change was predicted to abolish interactions between residues 93 and 117, with no compensating interactions. Conclusion: We confirm the extracellular location of Scianna residues responsible for antigen expression which predicts direct accessibility to antibodies. Loss of intraprotein interactions appear to be responsible for a Sc null and production of anti‐Sc3 with p.117Cys, SC*01 N.03, and for loss of a high prevalence antigen with p.73Cys, termed SCAC for Sc Arg to Cys. Comparative modeling aids our understanding of new alleles and Scianna antigen expression. [ABSTRACT FROM AUTHOR]

Introduction: Serological tests based on the detection of specific IgG and IgM antibodies are the primary diagnostic methods for Toxoplasma infection. Prompt diagnosis of maternal seroconversion during pregnancy is necessary to prevent transmission to the foetus, by means of specific treatment, and also to permit close monitoring of at-risk foetuses and neonates. Material and Methods: This prospective multicentric study was conducted to evaluate the seroprevalence of T. gondii in humans and to determine various risk factors and psychiatry comorbidity associated with the disease. During the study, samples were collected from randomly selected pregnant women at various centres.Sera were sent to laboratory for antibody detection by ELISA. Proper history was recorded and psychiatry evaluation was done. Results: Most of patients belonged to 31-40 years (28.3%) followed by 21-30 years (21.6%), 41-50 years (18.3%) and least were belongs to 15-20 years (15%). Most of the patients showedFever, Lymphadenopathy, Abdominal pain as presenting symptoms. In our study, women reported higher scores of somatization, depression and phobic anxiety.Eating of raw undercooked meat and Inappropriately washed vegetables were identified as two important risk factors for maternal toxoplasmosis. Conclusion: Although most immunocompetent individuals infected with toxoplasmosis remain asymptomatic throughout life, this parasite can cause many complications in immunocompromised patients and in pregnant women. Newborns presenting with congenital toxoplasmosis can be asymptomatic but can also develop retinochoroiditis and serious CNS complications . So, if women conceive, they should be educated regarding their eating habits and the value of good hygiene at the first visit for antenatal care. Health education for women of childbearing age is extremely important to prevent maternal toxoplasmosis. [ABSTRACT FROM AUTHOR]

Background: Estimation of residual risk (RR) is necessary to understand status of blood safety with current testing strategies and need to improve it further. These estimates from India are lacking till date. Present study was aimed to estimate RR and incident rate (IR) of transfusion transmitted infectious disease (TTIDs) in Indian setting. Study Design and Methods: Blood donor demographic data, serological testing results and nucleic acid testing (NAT) screening results were collected retrospectively from January 2015 to June 2017. Mathematical modelling using NAT yield/window period model was done to estimate IR and RR of TTIDs. Data was compared between different groups based on age‐group, gender, donation repeatability and type of donor. Results: A total 106 119 blood donors donated 109 441 units with overall TTID reactivity of 2.22%. HBV was most prevalent TTID (1.26%) with RR of 16.1 per million followed by HCV and HIV with RR of 4.4 and 3.1 per million donations, respectively. NAT testing variably reduced RR ranging from 69.4% to 96.1% depending on TTID. Younger, repeat and voluntary donors had significantly lower prevalence of TTIDs compared to older, first time and replacement donors. Discussion: Gaps in the blood safety could be bridged significantly by implementing NAT testing and using quality serological assays. Comparatively high RR despite using quality serological assays and ID‐NAT testing highlights need to develop long term strategies to improve blood safety by focusing on improving donor pool by recruiting regular voluntary donors among youth and imparting knowledge of healthy practices. [ABSTRACT FROM AUTHOR]

Purpose: The association between exposure to Toxocara canis and epilepsy is at the best contentious. Most of previous studies were retrospective, community-based, and contradictory to one another. As the impact of a positive association on the magnitude of epilepsy will be huge especially in developing countries where toxocariasis is common owing to poor hygienic practices, this study was carried out to determine whether exposure to T. canis predisposes to development of epilepsy. Patients and Methods: This case-controlled observational study was carried out a tertiary healthcare center in North India on 120 patients with newly diagnosed epilepsy who presented within 3 months of diagnosis. A total of 120 age- and sex-matched individuals from the same community were chosen as controls. Epilepsy was defined according to ILAE 1993 definition. Serological testing for T. canis was carried out using commercially available ELISA kits. All the positive samples were subjected to Western blot testing for confirmation. Results: The prevalence of antibodies to T. canis was similar in cases (16/120; 13.3%) and controls (16/120; 13.3%). Among the various risk factors, history of pica was significantly associated with T. canis seropositivity, while lack of hand washing was significantly associated with higher risk of epilepsy. Conclusion: Our study could not find any association between exposure to T. canis and epilepsy. [ABSTRACT FROM AUTHOR]

Background Nucleic acid amplification testing (NAT) for the screening of blood donations is known to improve blood safety. The decision to initiate NAT requires careful deliberation of infrastructure, skilled manpower, and financial resources. This report outlines the initiative of the Government of Odisha to implement NAT screening in government blood banks in the state of Odisha, India, through public–private partnership (PPP) and evaluates the incremental yield of minipool NAT screening over serology testing of blood donations. Methods Blood donations collected between June 2016 and September 2018 were initially screened for HBV (HBsAg), HCV (anti-HCV), and HIV (anti-HIV-1 and HIV-2) by ELISA, and syphilis and malaria. Sero-nonreactive donations were further screened in pools of six by Roche cobas TaqScreen MPX test version 2.0 (MPX2) NAT. Results On screening 3,39,472 blood donations, 1.34% seroreactive donations were detected. In all, 847 NAT-reactive donations (0.26%): 693 HBV, 58 HCV, and 96 HIV were detected. The NAT yields were 1:386 overall, 1:472 for HBV, 1:5642 for HCV, and 1:3409 for HIV. Conclusion NAT testing using the highly sensitive MPX2 assay leads to incremental detection of TTIs over serology. Implementation of NAT along with serological testing in blood centers all over India will be an important step towards providing safe blood. Our study not only highlights the benefits of minipool NAT testing but also presents a scalable PPP model that can serve as a template for application across other states. [ABSTRACT FROM AUTHOR]

Background: Glanders is a transmissible zoonotic disease caused by Burkholderia mallei that infects equids and humans. No glanders cases in equids were reported so far in Nepal. Case presentation: Following suspected glanders in animals with clinical signs in different regions in Nepal, serum samples were tested by CFT, ELISA and Luminex® tests. Two horses and a mule tested positive for glanders by all tests, while two other equids only tested positive by ELISA and Luminex®. Analysis of swabs and pus samples by a PCR system targeting B. mallei confirmed the presence of the bacterium in the samples collected from the 3 equids that yielded positive results in all serological tests. Genotyping of the three PCR positive samples with a SNP-based method identified a genotype closely related to the B. mallei strains circulating in India. Conclusion: Confirmation of glanders cases underscores the need of implementing a surveillance program in Nepal and a strict control of the animal movement across the borders. [ABSTRACT FROM AUTHOR]

Subjects undergoing hemodialysis have enhanced vulnerability to hepatitis C virus (HCV) infection due to invasive procedures and poor infection control practices. Early detection and treatment are essential to prevent cross-infection and mortality/morbidity. However, common use anti-HCV antibody tests lack the necessary accuracy, and alternative tests (e.g. core antigen detection kits) which are available need to be examined as a viable alternative. A total of 270 continuous serum samples were collected from patients undergoing dialysis within 15 months of study period. Sequentially, multiple tests were performed – immunochromatography-based rapid test, third-generation ELISA i.e. (anti-HCV antibody detection), fourth-generation ELISA (HCV antigen–antibody combined detection assay), and HCV RNA quantitative real time polymerase chain reaction (qPCR) assay. Diagnostic parameters of serological kits were compared in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and so on. Statistical Package for the Social Sciences was used. HCV-combined core antigen–antibody assays performed better than other serological assays in reference to the gold standard HCV RNA. This fourth-generation assay yielded a Kappa value of 0.947 compared with the value of 0.747 and 0.619 for anti-HCV ELISA and rapid detection test. Other parameters such as sensitivity, specificity, PPV, NPV, and so on were also better for fourth-generation ELISA compared with third-generation ELISA and other serological assays. HCV RNA was negative in 7.3% of anti-HCV–positive patients and was detected in 11.4% of anti-HCV ELISA–negative patients. In about 1.6% of HCV RNA–positive cases, fourth-generation ELISA was negative and had low HCV viral load (650 IU/ml and below). Fourth generation ELISA detected additional 7.4% HCV positive cases (compared to third generation kits) and upon cost effective analyis, additional cost to be bear for the better detection (by fourth generation kit) was found to be only INR 27 per 1% increased case detection. In resource scant setup, screening and follow-up of patients undergoing hemodialysis can be performed by fourth-generation HCV ELISA (antigen–antibody combined assay) instead of the current practice of anti-HCV antibody ELISA. Better yield in detection rate will compensate for slight addition to costs. [ABSTRACT FROM AUTHOR]

Background: The HLA associations of celiac disease (CD) in north Indians differ from that in Europeans. Our dietary gluten is among the highest in the world. Data on CD in people with diabetes (PWD) in north India is scant. Objective: To estimate the prevalence and clinical profile of CD in children with type 1 diabetes (T1D). Research Design and Methods: Retrospective review of case records of PWD with onset ≤18 years of age, registered between 2009 and 2020, having at least one anti tissue‐transglutaminase (anti‐tTG) serology report. Results: Of 583 registered PWD, 398 (68.2%) had celiac serology screening. A positive report was obtained in 66 (16.6%). Of 51 biopsied people, 22 (5.5%) were diagnosed to have CD, 12 in the first 2 years of diabetes onset. Symptomatic CD at diagnosis was seen in 63% (14/22). Age at diabetes onset (median [IQR] age 5.5 years, [2–12]) was lower in PWD and CD compared to PWD alone (10 years, [7–14], p < 0.016). Of 36 biopsied children with anti‐tTG >100 au/ml, 20 (55.5%) had CD, while 2 out of 15 (13.3%) of those with lower anti‐tTG titer had histopathology suggestive of CD. Of 23 seropositive children not diagnosed with CD, 5 of 8 with anti tTG >100 au/ml, and all 15 with lower anti‐tTG, had normalization of titers over the 24 (10–41) months. Conclusions: Our prevalence of CD is comparable to international data. Celiac disease was common with younger age at onset of T1D and higher titer of celiac serology. A high proportion was symptomatic of CD at diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the clinico-epidemiologic characteristics of optic neuritis based on the status of serum aquaporin-4 antibody (AQP4-Ab) in patients with optic neuritis (ON).Methods: Medical records of 106 patients with ON and a follow-up of 3 years were reviewed. For each patient, the following data were extracted: medical history, findings of the ocular examination, brain, orbital or spinal MRI, and serological tests for AQP4. The ON was classified as typical or atypical based on disc examination and improvement in vision after intravenous methylprednisolone (IVMP). The clinical findings (typical or atypical), disease course, and outcomes were analyzed according to the serostatus of the ON.Results: 10 patients ((9.4%) were seropositive for AQP4-Ab; all had atypical ON. 96 patients (91%) were seronegative for AQP4-Ab: 36 atypical ON and 60 typical ON. Profound visual impairment at presentation was seen in all patients. However, at the end of the study period, seropositive and seronegative atypical ON had poor visual outcomes as compared to seronegative typical ON (P = 0.002). Five seropositive and four seronegative patients with atypical ON developed transverse myelitis. Bilateral disease with relapse was more in seropositive patients (80%); however, seronegative with atypical ON also had bilateral presentation and relapse in 42% and 41%, respectively.Conclusion: AQP4-Ab seropositive patients mostly present with atypical features such as bilateral recurrent ON, poor visual outcome, and increased incidence of transverse myelitis. However, atypical clinical features can also be seen in seronegative ON with a poor visual outcome and a recalcitrant course. [ABSTRACT FROM AUTHOR]

Background: Subsequent to serosurveys 1 and 2 for COVID-19 carried out in three wards of Mumbai in July and August 2020, Municipal Corporation of Greater Mumbai conducted serosurvey 3 in March 2021. This was to identify the extent of exposure by testing specific IgG antibodies against COVID-19. Material and Methods: A cross-sectional study was conducted to find the prevalence of seropositivity in Mumbai, which included 10,197 samples belonging to patients visiting public dispensaries (slum population, 6006) and private (nonslum population, 4191) laboratories of Aapli Chikitsa network for blood investigations for non-COVID illnesses. The ward-wise number of unlinked anonymous samples from 24 wards was predecided by using probability proportionate sampling. The samples were collected using quota sampling technique as per predecided sample for each ward. These samples collected from nonimmunized individuals were tested for IgG antibodies at the Molecular Biology Laboratory of Kasturba Hospital for Infectious Diseases by chemiluminescence assay (CLIA) method. Results: The overall seropositivity was found to be 36.3% (41.6% in slum and 28.59% in nonslum population). It was more in city wards (38.28%) followed by western suburb (36.47%) and then eastern suburb wards (34.86%), matching with the proportion of cases in these wards during the study period. There was no significant difference in seropositivity among males and females and in different age groups. Conclusions: Seropositivity is higher in slum areas than nonslum areas. It has reduced in slum areas and increased in nonslum areas as compared to findings of serosurveys 1 and 2. This explains the detection of a greater number of cases from nonslum areas in the second wave. The average seropositivity of 36.3% justifies the necessity of immunization on a wider scale in the city. Periodic serosurveys are required at fixed intervals to monitor the trend of infection and level of herd immunity. [ABSTRACT FROM AUTHOR]

SARS-CoV-2, the mighty manslayer, responsible for COVID-19, has currently killed over 1.54 million people worldwide and 141,000 in India alone. It has affected around 67 million people globally and 9.68 million in India. It has quarantined the whole world. Doctors and scientists are working around the clock to save the world from this deadly virus. Since the number of patients is increasing rapidly, it is essential to test as many suspects as possible. But with the diagnostic tests that are being used currently, the polymerase chain reaction, antibody detection (Serological tests), Rapid Diagnostic tests (RDT), antigen tests and Isothermal Amplification assays are time consuming and there is a high chance that the test might come back with the wrong results. SHERLOCK and DETECTR are CRISPR-based diagnostic tool that were recently worked upon and showed very promising results. The test results come back in less than 40 minutes and the tests are far more accurate than all of the current diagnostics which makes them far more efficient than the others. [ABSTRACT FROM AUTHOR]

Epidemiological and clinical features of demyelinating disorders in the Indian context have been sparsely reported. This paper aims to provide a review of literature from the past decade on the same. PubMed, Google scholar, and PubMed search databases were searched using subject headings and key words for data from the past 10 years (1999‐2019). Data from studies that collected Incidence and prevalence of demyelinating disorders were prioritized. In addition, clinical and demographic features of demyelinating disorders were obtained from hospital‐based studies published from different regions within India. The sole epidemiological study from India showed a prevalence of multiple sclerosis (MS) among Indians to be 8.3/100 000 and that of neuromyelitis optica spectrum disorders (NMOSD) to be 2.7/100 000. Clinical features of MS obtained from hospital‐based studies showed female predominance, an onset of disease predominantly in the second decade of life and pyramidal dysfunction as a common initial attack. Aquaporin 4‐IgG‐associated NMOSD were predominantly in woman with myelitis as the most common initial attack. In contrast, MOG‐IgG‐associated disorders showed no gender bias and presented often with optic neuritis. There is growing awareness of demyelinating disorders in India, and the availability of imaging and serological tests has allowed for accurate and early diagnosis. In the absence of large epidemiological studies at the national level, there is likely to be a significant underestimation of prevalence and incidence of these diseases. [ABSTRACT FROM AUTHOR]

Tuberculosis is a highly contagious zoonotic disease caused by Mycobacterium spp. A study was conducted to detect the presence of Mycobacterium in captive elephants. A total of 15 captive elephants were screened from various regions in Maharashtra. The blood and serum samples collected were subjected to rapid test kit, BacT/ALERT 3D system, Ziehl-Neelsen (ZN) staining and PCR. All the samples were found seronegative using rapid test kit and whole blood PCR. Whereas, all samples were signalled culture positive in BacT/ ALERT 3D system which were further subjected to PCR, only one amplicon was produced of 176bp of RD4 gene (Mycobacterium bovis) and no acid-fast organism was detected upon ZN. Due to the atypical nature of this organism, diagnosis of this disease in elephants using various tests is complicated unlike the diagnostic tests that are validated in domestic animals. Therefore, many tests have sub-optimal sensitivity and specificity in elephants. As TB is a zoonotic disease, transmission can occur between human-livestock-elephants interface. Therefore, the zoos and state forest authority should inculcate a protocol of periodic TB screening for Mahouts and elephants in captivity along with protocol of elephant-visitor interaction, thus helping in conservation of this endangered species in India. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Serodiagnosis of Tuberculosis in Asian Elephants (Elephas maximus) in Southern India: A Latent Class Analysis." The correction addresses an issue with the ponceau loading control panels in Figure 1F and 1L, which appear more similar than expected. The original uncropped images are no longer available, but replicate data is provided. The authors also provide an updated version of Figure 1 with replicate image data and original uncropped images for Western blotting and ponceau staining. The raw data for Figure 1G and the summary results in Tables 1-3 are no longer available, but the original underlying data for all other results in the article and supporting information files are available. The authors apologize for the error. [Extracted from the article]

Purpose: The objective of this study was to correlate seasonal variation of epidemic retinitis (ER) with concurrent community outbreaks.Methods: This is a retrospective, observational, comparative study conducted in a tertiary care eye hospital in south India. Monthly variation in number of ER cases in comparison with reported community outbreaks by Integrated Disease Surveillance Program (IDSP) from 2009 to 2020 in the same region were studied. Month-wise graphs against number of patients were plotted for ER and for each community outbreak.Results: ER was diagnosed in 163 patients. Diagnosis of presumed rickettsial ER was made in 48 cases (29.44%), chikungunya in 5, dengue in 3 and typhoid in 6 cases, while in other cases the etiological diagnosis remained uncertain (n = 101). Multiple positive serological tests were seen in 6 patients (Weil Felix Test (WFT) with WIDAL in 4 and chikungunya IgM with WFT in 2 patients). Relevant reported outbreaks by IDSP were: Pyrexia of unknown origin (PUO) (n = 5148), Chikungunya (n = 6577), Dengue (n = 7350), Measles (n = 1422), Mumps (n = 881), Rubella (n = 288), Malaria (n = 2262), Chicken Pox (n = 2385), Typhoid (n = 597), Kyasanur Forest Disease (n = 381), Scrub Typhus (n = 13), Typhus fever (n = 4), Japanese Encephalitis (n = 15). None of the outbreak graphs pattern was identical or similar to the graph of ER. Inverse relation of the graph of dengue outbreak with ER was observed.Conclusion: Inverse correlation between dengue and ER should be further studied for causation, which we believe may prove dengue as least common cause. Reporting of rickettsial outbreaks should be enhanced by undertaking statewide awareness and procurement of gold standard tests. [ABSTRACT FROM AUTHOR]

Glanders is a fatal bacterial infection of equids caused by Burkholderia mallei. The infection can be transmitted to humans through prolonged direct contact with glanderous equids. Recently, reemergence of equine glanders has been reported in many countries. To investigate zoonotic transmission of B mallei infection, sera were collected from 538 humans including equine handlers and veterinary professionals exposed to glanderous equids. Samples were tested by ELISA (enzyme-linked immunosorbent assay) and complement fixation test and found negative for B mallei –specific antibodies. Even though there was no incidence of human glanders during this survey period, occupational exposure will continue to remain a serious concern and a key risk factor. Therefore, we emphasize the need for intersectoral collaboration and coordination among veterinary, human, and public health authorities for continuous surveillance and monitoring of human glanders under one health concept. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B and C cause serious infectious disease of the liver which affects millions of people worldwide. More than 2 billion people living today have been infected with Hepatitis B virus (HBV) at some time in their lives and about 350 million people are carriers of the virus. Aim: To detect HBV and HCV infection and assess HBV immunity status amongst healthcare workers, medical students and nursing students at AIIMS Rishikesh. Methods: 135 participants (Medical faculty, Nursing Faculty, Resident Doctors, laboratory technicians, laboratory attendants, medical and nursing students) were enrolled for the study. Serological tests HBsAg, anti-hepatitis C virus antibodies (anti-HCV), anti-HBs antibodies, were performed. None were positive for HBsAg 1.5% were positive for Anti HCV antibodies and 61.75% had protective levels of antiHBs. Conclusion: HBV vaccination and screening for HBV, HCV, and anti-HBs of all HCW and students at time of entry should be done. Yearly screening thereafter should be done to check as follow up. Regular training on HBV vaccination and safe practices should be emphasized at all levels of HCW. [ABSTRACT FROM AUTHOR]

It is an emerging zoonotic disease spread all over the world, but its diagnosis is rather complex. Though a number of serological tests are currently available for diagnosis, none of them are useful at POC diagnosis. Further, they are not user-friendly and reproducible. Precisely for this reason, present study was aimed to develop a simple, inexpensive, field applicable POC diagnostics using protein G-based milk dipstick and indirect enzyme-linked immunosorbent (iELISA) assays. These are useful for rapid detection of brucellosis using a handheld ELISA reader at resource-limited POC areas near pen side. Overall, 4998 raw milk and whole blood samples were collected from organized dairy farms, where animals are reared (Goshalas), and villages in different districts of Andhra Pradesh and Telangana states, India. Collected samples used to evaluate diagnostic performances of these assays in comparison with milk ring test (MRT) and Rose Bengal Plate Test (RBPT) serological assays. The developed milk dipstick and iELISA showed 87.37%, 99.67% and 98.23%, 100% sensitivity and specificity respectively. Results proved that the developed assays can be used as potential diagnostics for rapid field diagnosis of Brucellosis from infected animals using raw milk and whole blood samples at resource-limited settings. [ABSTRACT FROM AUTHOR]

Tests for visceral leishmaniasis (VL) are not uniformly effective for all endemic regions. In a serological assay, a novel antigen, otubain cysteine peptidase, compared with rK39, showed comparable sensitivity with Indian VL serum samples and prominently increased sensitivity with Brazilian samples, as well as improved monitoring of the treatment response. [ABSTRACT FROM AUTHOR]

Background: Listeriosis a serious food-borne illness, most often affects pregnant women, the unborn, newborns and the immunocompromised. Infection in pregnant women results in intrauterine infection, preterm labor, spontaneous abortion, still birth and neonatal meningitis/sepsis leading to high morbidity and mortality. The present study aimed to detect human listeria antibody in pregnant women and neonates visiting Government general hospital, Puducherry, India using a rapid serological assay (ELISA). Study Design: A cross sectional study. Method: A total of 269 samples which includes 125 serum samples from pregnant women, 34 serum samples from women with bad obstetric history, 91 serum samples from neonates and 19 CSF samples from neonates collected were tested for Human Listeria Antibody IgM (LST-IgM) ELISA. Results: Out of 269 cases tested 51 (19.0%) were found positive for listeria antibody. Of the 125 pregnant women tested 43 (34.4%) were seropositive, Among the 34 women with bad obstetric history 7 (20.6%) and of the 110 neonatal cases only 1(0.93%) case showed seropositive for Listeria antibody.16/34 (47.1%) of pregnant women in first trimester, 5/18(27.8%) women with preterm labor were reported seropositive for Listeria.35/51 (68.6%) of seropositive cases had only fever. Conclusion: The overall seropositivity of Listeriosis in pregnant women and neonates was to the tune of 19.0%. To conclude any pregnant women with a fever or flu like symptoms with or without gastrointestinal symptoms needs to be diagnosed for Listeriosis. Moreover Listeriosis being a foodborne infection, information regarding avoidance of certain foods in Pregnancy can be incorporated into formal antenatal education in addition pregnant women need to be cautioned regarding the feto-maternal consequences of Listeriosis infection in pregnancy. [ABSTRACT FROM AUTHOR]

Objectives: Many community-based and hospital-based studies across the world have yielded contradictory results regarding association of positive Toxocara canis serology and epilepsy. The present study was planned to analyze disease burden of epilepsy in rural community of North India and its association with exposure to T. canis in this part of the world. Methods: A door-to-door screening survey was carried out in the rural community using a validated questionnaire for epilepsy by trained field workers, which was finally confirmed by trained neurologists. The risk factors for epilepsy and for predisposing infections were also enquired. The results were compared with an equal number of age- and sex-matched healthy controls enrolled from the same community. Serologic evaluation was carried out to detect antibodies against T. canis. Results: A total of 41,973 persons from the rural community in 49 villages were enrolled in the study. Two hundred and eleven persons were confirmed to be suffering from active epilepsy, resulting in a crude prevalence of 5 per 1000 population. More than 50% of people with epilepsy were in the second or third decade of life. The prevalence of antibodies to T. canis was similar in people with epilepsy (13.7%; 29 of 211 individuals) and controls (9.95%; 21 of 211 individuals). Of the 151 persons with epilepsy, who underwent CT scan, 34 people (22.3%) had evidence of inflammatory granuloma, thereby confirming high incidence of this infestation in rural Northern India. Significance: Our study does not support the association between epilepsy and exposure to T. canis in rural Northern Indian population. [ABSTRACT FROM AUTHOR]

Rowell's syndrome (RS) is recognized since 1963 as a presentation of lupus erythematosus (LE) with erythema multiforme-like lesions and characteristic immunological changes. Antiphospholipid syndrome (APS) encompasses antibodies to phospholipids/phospholipid-binding cofactor proteins and/or circulating lupus anticoagulant with clinical manifestations of thrombosis such as recurrent spontaneous abortions, etc. A 32-year-old female with primary infertility since marriage (7 years) and sequential appearance, for the past 6 months, of various lupus-specific cutaneous lesions, "targetoid" lesions on palms, musculoskeletal, ocular and auditory (sensorineural hearing loss [SNHL]) complaints with positive serological profile for SMD-1, SS-A/Ro, SS-B/La, U1-snRNP, Ku, antiphospholipid and anticardiolipin antibodies, and histopathologically confirmed LE is presented as a case of concurrent overlap syndrome, RS and APS, primary infertility, and SNHL. A brief review of RS including analysis of data of cases reported from India hereto vis-a-vis that of cases worldwide up to 2012 has also been done. [ABSTRACT FROM AUTHOR]

Prior to the advent of the Wasserman Test as a diagnostic tool for Syphilis, the identification rate for Syphilis at the Mysore Government Mental Hospital in Southern India was 1%. With the introduction of the test, there was a dramatic increase in the diagnosis of Syphilis, with 17% of the patients testing positive. This paper throws light on the early notions of Syphilis and GPI, societal responses to the disease, early misdiagnosis, the advent of the Wasserman test and treatment management as reflected in the records of the early 20th century at the Mysore Government Mental Hospital (currently known as NIMHANS). [ABSTRACT FROM AUTHOR]

Background: Nail involvement in psoriasis is common with a lifetime incidence of 80-90%. It may reflect severity of cutaneous involvement and predict joint disease. Yet it remains, poorly studied and evaluated especially in Indian psoriatic patients.Aim: The present study was undertaken to evaluate clinical and serological profile of nail involvement in psoriasis and to assess quality of life impairment associated with nail involvement in Indian patients.Methods: Consecutive patients with nail psoriasis were assessed for severity of cutaneous disease (psoriasis area severity index score) and nail disease (nail psoriasis severity index score). The impairment in quality of life attributable to nail disease was scored with nail psoriasis quality of life 10 score. All patients were also assessed for joint disease and tested for inflammatory and serological markers as erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and anti-cyclic citrullinated peptide antibodies.Results: In our cohort of 38 patients with nail psoriasis, 9 had concomitant psoriatic arthritis. The mean psoriasis area severity index was 14.4 ± 9.6 (range = 0.4-34). The most commonly recorded psoriatic nail changes were pitting (97.4%), onycholysis (94.7%) and subungual hyperkeratosis (89.5%). The mean nail psoriasis severity index score was 83.2 ± 40.1 (range = 5-156) and mean nail psoriasis quality of life 10 was 1.1 ± 0.4. Erythrocyte sedimentation rate and C-reactive protein were raised in 22/38 (57.9%) and 15/38 (39.5%) patients, respectively; rheumatoid factor was positive in 5/38 (13.2%) and anti-cyclic citrullinated peptide antibody was raised in 4/38 (10.5%) patients.Limitations: Small sample size and lack of a control group.Conclusions: In Indian patients with nail psoriasis, severity of nail involvement was found to be poorly correlated with the extent of cutaneous disease. In addition the impact of nail disease on patient's quality of life was found to be minimal. This suggests the need for a quality of life questionnaire suited to the Indian population. Serological markers were raised overall in the study patients and more so in the patients with concomitant arthritis. [ABSTRACT FROM AUTHOR]

Background: Rhnull phenotype is an extremely rare condition characterized by no expression of Rh antigens at the surface of red blood cells. Although rare, genetic bases of this phenotype are well known and include mutations within either the RH (RHD and RHCE) genes or the RHAG gene. So far Rhnull has been reported in individuals of Caucasian, African, and Asian origin. Here, we report individuals from two families of Indian origin representing such a rare phenotype.Study Design and Methods: Serologic analysis was carried out by testing with anti-D, -C, -c, -E, and -e in Rhnull individuals and their family members. RH genes were analyzed by standard molecular approaches, including Sanger sequencing and quantitative multiplex polymerase chain reaction (PCR) of short fluorescent fragments. RHAG gene was investigated by exon-specific PCR amplification and Sanger sequencing.Results: In one family, RHAG gene was found to be deleted at the homozygous state in the propositus, suggesting Rhnull of the regulator type. In the other family, a novel splice site variant in RHCE in cis with whole RHD gene deletion was identified at the homozygous state. Further functional analysis by minigene splicing assay showed that this variation, that is, c.801 + 1G>A, completely impairs normal splicing, then inactivating the expression of RhCE protein. Contrary to the former case, these data suggest Rhnull of the amorph type.Conclusion: Overall, we report for the first time the molecular mechanisms responsible for Rhnull phenotype in individuals of Indian origin. This study contributes to extend the molecular spectrum of variations in Rhnull individuals. [ABSTRACT FROM AUTHOR]

Background: Brucellosis is an important zoonotic disease caused by different Brucella species and human brucellosis is commonly prevalent in different states of India. Among various Brucella species, B. melitensis is most pathogenic to human and included as category B biothreat which can cause infection through aerosol, cut, wounds in skin and contact with infected animals. The diagnosis of human brucellosis is very important for proper treatment and management of disease as there is no vaccine available for human use. The present study was designed to clone, express and purify immunodominant recombinant omp2a (rOmp2a) porin protein of B. melitensis and to evaluate this new antigen candidate for specific serodiagnosis of human brucellosis by highly sensitive iELISA (indirect enzyme linked immunosorbent assay).Method: Omp2a gene of B. melitensis 16 M strain was cloned and expressed in pET-SUMO expression system. The recombinant protein was purified under denaturing conditions using 8 M urea. The purified recombinant protein was confirmed by western blotting by reacting with anti-HIS antibody. The sero-reactivity of the recombinant protein was also checked by reacting with antisera of experimentally infected mice with B. melitensis 16 M at different time points. Serodiagnostic potential of recombinant porin antigen was tested against 185 clinical serum samples collected from regions endemic to brucellosis in southern part of India by iELISA. The samples were grouped into five groups. Group 1 contained cultured confirmed positive serum samples of brucellosis (n = 15), group 2 contained sera samples from positive cases of brucellosis previously tested by conventional methods of RBPT (n = 28) and STAT (n = 26), group 3 contained sera samples negative by RBPT(n = 36) and STAT (n = 32), group 4 contained sera samples of other febrile illness and PUO case (n = 35) and group 5 contained confirmed negative sera samples from healthy donors (n = 23).Result: The rOmp2a was found to be immunoreactive by iELISA and western blotting. The test showed a sensitivity of 93.75% and specificity of 95.83% when tested against 185 serum samples. For determination of statistical significance between experimental groups and control groups, Student's t test was performed on the data.Conclusion: Omp2a emerges as a potential antigen candidate for serodiagnosis of human brucellosis. [ABSTRACT FROM AUTHOR]

Background Global burden of dengue is substantial, with an annual incidence of 50 million cases. India has witnessed gradual rise in its incidence, mainly from urban regions. North-eastern India, hitherto non-endemic for dengue, has reported sporadic cases of dengue lately. Objective To study the clinical profile of dengue in north-east India. Method and material Clinical profile of 218 dengue patients (≥15 years) was studied in a hospital-based observational study. Dengue was diagnosed by WHO criteria and confirmed by NS1 antigen and/or dengue specific IgM ELISA tests. Statistical analyses were done using SPSS and STATA Data analysis and statistical software. A ‘p value’ <0.05 was considered significant. Results There was male preponderance (58.7%), affecting mainly younger (15–34 years) subjects (73.85%). Majority (96.33%) were without travel history, none had dengue previously. Serological confirmation was present in 77.06%. On admission, mean haemoglobin and platelet counts were low with normal leucocyte count and haematocrit. Platelet and leucocyte counts declined during hospital stay; 8.25% developed severe thrombocytopenia (<10000/mm 3 ) necessitating platelet transfusion, 17.43% developed leukopenia. Systemic hypotension was found in 13.3%. Mortality was nil and average hospital stay was 5.36 days. Conclusion First attacks of dengue without travel history, in a hitherto non-endemic region suggest recent endemicity. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection continues to be a life- threatening health problem throughout world, infecting more than two billion people. While blood transfusion and unsafe therapeutic injection continue to be major risk factors, the role of vertical transmission remains under- estimated. Hence, this study was done to find out the prevalence of HBV infection and associated risk factors among healthy pregnant ladies in Southern Odisha. The present study was a prospective, observational study conducted, in the department of Microbiology, with collaboration of department of Obstetrics and Gynecology of MKCG Medical college from 1st March 2017 to 28th Feb 2018. Methodology: After collection of three to four millilitre of venous blood from the clients, sera was separated by centrifugation. They were then tested for Hepatitis B surface antigen (HBsAg) by Enzyme linked Immunsorbent assay (ELISA). Serological status of the subjects and correlation with their socio-economic characteristic was noted using a preset proforma. Babies born to HBsAg positive ladies were administered Hepatitis B vaccine and immunoglobulin. Results: Total 3,230 in non-duplicating serum samples were screened among which 150 (4.64%) were tested positive for HBsAg. Ladies with multiple sexual partners (57. 14%) followed by intravenous drug users (7.88%) were mostly positive for HBsAg. Conclusion: Exposure to risky social behavioural pattern, lack of awareness could be suggested as possible means of acquiring the infection. Immunization is the most effective and only way of preventing development of chronic carrier state. Hence all neonates were administered with hepatitis B vaccine and 0.5 ml of hepatitis B immunoglobulin within 12 hours of birth. [ABSTRACT FROM AUTHOR]

Background: Patients with Post kala-azar dermal leishmaniasis (PKDL) are considered a reservoir of Leishmania donovani. It is imperative to identify and treat them early for control of visceral leishmaniasis (VL), a current priority in the Indian subcontinent. We explored trends in clinico-epidemiological features of PKDL cases over last two decades, for improving management of the disease.Methods: Clinically suspected cases were diagnosed with rK39 strip test followed by parasitological confirmation by microscopy and/or PCR/qPCR in skin tissue/slit aspirates. Patients were treated with antimonials till 2008 and subsequently with miltefosine.Results: The study indicated higher incidence of PKDL cases in areas of high endemicity for VL, with 20 % cases reporting no history of VL. Approximately 26 % cases of PKDL were initially misdiagnosed at primary health centers. Duration between onset of PKDL and diagnosis was above 12 months in 80 % cases. Diagnostic sensitivity was 32-36 % with microscopy and 96-100 % with PCR/qPCR. Compliance to treatment was over 85 % with miltefosine while 15 % with antimonials. Relapse rate with miltefosine was up to 13.2 %.Conclusions: PKDL patients tend to delay reporting and are often misdiagnosed. Confirmatory diagnosis using minimally invasive skin slit aspirate samples would help overcome such issues. There was a paradigm shift in compliance with miltefosine; however, increasing relapse rate indicated the need for newer therapies with oral formulations. [ABSTRACT FROM AUTHOR]

Background: It is usually difficult to diagnose brucellosis clinically in the absence of specific clinical features. Hence serological testing forms the mainstay of diagnosing the disease. Seroepidemiological determinants of brucellosis in rural western Maharashtra have not been closely investigated. Aim: The present study was therefore conducted to determine the incidence and to analyze seroepidemiological determinants of Brucellosis in cases of pyrexia of unknown origin (PUO) in rural western Maharashtra. Material and methods: The present hospital based cross sectional survey was carried out in Rural Medical College, Loni on 500 cases of PUO. SPSS version 20.0 was used for analysis. The serum samples were subjected to serological tests like Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT). The inoculated agar plates were watched daily for the presence of growth Brucella on culture. Results: Males (51.6%) outnumbered females (48.4%) in the study sample. Out of 500 cases 10 samples showed the presence of Brucella agglutinins. The male female ratio in the seropositive cases was 2.33:1. Headache and joint pain was observed in 5 and 3 cases respectively. 50% samples yielded the growth of Brucella on culture. All the culture positive samples had titer of 640 IU or more. Conclusion: Agglutination test if properly performed can be used as a very dependable laboratory procedure for rapid diagnosis of Brucellosis. [ABSTRACT FROM AUTHOR]

The article discusses the study on human brucellosis in rural India, that determined its serological, clinical, and epidemiological profile, as well as associated risk factors, using Rose Bengal Plate test (RBPT), Serum Agglutination test (SAT), and 2-Mercaptoethanol test (2-ME). Findings discussed include major risk factors such as animal contact particularly during milking, parturition/abortion, and raw milk ingestion, and RBPT, SAT, and 2-ME positivity rates.

Introduction: Studies employing serological, DTH or conventional PCR techniques suggest a vast proportion of Leishmania infected individuals living in regions endemic for Visceral Leishmaniasis (VL) remain asymptomatic. This study was designed to assess whether quantitative PCR (qPCR) can be used for detection of asymptomatic or early Leishmania donovani infection and as a predictor of progression to symptomatic disease. Methods: The study included 1469 healthy individuals living in endemic region (EHC) including both serology-positive and -negative subjects. TaqMan based qPCR assay was done on peripheral blood of each subject using kDNA specific primers and probes. Results: A large proportion of EHC 511/1469 (34.78%) showed qPCR positivity and 56 (3.81% of 1469 subjects) had more than 1 calculated parasite genome/ml of blood. However, the number of individuals with parasite load above 5 genomes/ml was only 20 (1.36% of 1469). There was poor agreement between serological testing and qPCR (k = 0.1303), and 42.89% and 31.83% EHC were qPCR positive in seropositive and seronegative groups, respectively. Ten subjects had developed to symptomatic VL after 12 month of their follow up examination, of which eight were initially positive according to qPCR and among these, five had high parasite load. Discussion: Thus, qPCR can help us to detect significant early parasitaemia, thereby assisting us in recognition of potential progressors to clinical disease. This test could facilitate early intervention, decreased morbidity and mortality, and possibly interruption of disease transmission. Author Summary: Anthroponotic VL caused by Leishmania donovani in the Indian subcontinent accounts for 70% of the world burden of VL. Among the estimated 100,000 cases of VL acquired annually in India, 90% occur in the state of Bihar. Leishmania infection can result in either symptomatic or asymptomatic infection. L. donovani infection can also manifest as post-kala azar dermal leishmaniasis, a chronic cutaneous form thought to provide the reservoir for anthroponotic transmission of VL in regions endemic for this parasite species. We hypothesized that, in areas endemic for L. donovani, asymptomatic infections might also play a crucial role in disease transmission. This study describes use of quantitative PCR (qPCR) to determine the infection status in individuals living in an endemic region of India. We hypothesized that parasite load estimation by qPCR of peripheral blood cells among healthy individuals living in the endemic region might reveal the true frequency of infections through direct evidence of parasitemia. We reasoned this test would detect both asymptomatic non-progressors as well as asymptomatic individuals who will progress to fully symptomatic VL. Serologic testing by ELISA or DAT showed poor agreement with molecular detection of parasite DNA by qPCR, suggesting the tests differentiate between infection and immune response. Amongst ten healthy individuals who progressed to VL, only six were serologically positive whereas eight were initially qPCR positive, among whom five had high parasite loads in their blood. Thus, deployment of qPCR technique to estimate the presence and level of parasitemia in healthy individuals from Leishmania endemic regions may contribute to early case detection, thereby reducing morbidity and mortality. Consistent with the goals of the VL control and elimination program, this early intervention approach could help interrupt disease transmission. [ABSTRACT FROM AUTHOR]

Retrospective serologic screening of 1077 serum samples collected from the primitive tribe from north-eastern India in 1963 revealed high prevalence of HBV (15% HBsAg carrier rate) and HCV (7% anti-HCV positivity) and co-circulation of multiple HBV genotypes-A, C, D and G. Full genome sequencing classified all the G-genotype samples as genotype-I. Comparison of genotype-I-HBV full-genome sequences representing 1963 ( n = 5, this study) and 2005 (reported earlier) showed identical recombination break-points of genotypes-A/G/C. Genotype-C and genotype-C-fragment of I-genotype circulating in 1963 were distinctly different. The data demonstrates that the recombination events were not recent. Molecular clock analysis predicted existence of genotype-I in this tribe during 1920s. [ABSTRACT FROM AUTHOR]

Abstract: Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira, causing febrile infection characterized by multi-organ failure in humans and animals. Leptospiral Ig-like protein B (LigB) is a surface-expressed antigen that mediates host cell invasion or attachment. In this study, N-terminal conserved region of LigB protein (46 kDa) was evaluated for its diagnostic potential to detect anti-leptospiral antibodies in the sera of various animal species. Dot blot analysis revealed immunoreactivity of Leptospira-positive sera of cattle, buffalo, dog, sheep and goat to purified LigB protein. We have analyzed 1126 bovine serum samples, collected from Northern and Eastern part of India, by microscopic agglutination test (MAT) and recombinant LigB (rLigB) based ELISA and latex agglutination test (LAT). The sensitivity of rLigB based ELISA for 554 MAT positive sera was 96.9% and the specificity with 572 MAT negative sera was 91.08% whereas LAT showed sensitivity and specificity of 93.68% and 92.31%, respectively. Kappa values of 0.879 and 0.860 for recombinant antigen based ELISA and LAT indicate excellent agreement with the gold standard serological test, MAT, for the detection of anti-leptospiral antibodies in sera. Further, LAT based on rLigB antigen is a simple and rapid test, suitable for serodiagnosis of leptospirosis under field conditions, owing to its portability and longer shelf life. [Copyright &y& Elsevier]

Copyright of Revista do Instituto de Medicina Tropical de São Paulo is the property of Instituto de Medicina Tropical de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Delayed or missed diagnosis of TB continues to fuel the global TB epidemic, especially in resource limited settings. Use of serology for the diagnosis of tuberculosis, commonly used in India, is another factor. In the present study a commercially available serodiagnostic assay was assessed for its diagnostic value in combination with smear, culture and clinical manifestations. Methodology/Principal Findings: A total of 2300 subjects were recruited for the study, but 1041 subjects were excluded for various reasons. Thus 1259 subjects were included in the study of which 470 were pulmonary tuberculosis cases (440 of 470 were culture-positive) and 789 were their asymptomatic contacts. A house-to-house survey method was used. Blood samples were tested for IgM, IgA, and IgG antibodies using the Pathozyme Myco M (IgM), Myco A (IgA) and Myco G (IgG) enzyme immunoassay (EIA). Out of 470 PTB cases, BCG scar was positive in 82.34%. The Mantoux test and smear positivity rates in PTB cases were 94.3% (430/456), and 65.32% (307/470), respectively. Among the asymptomatic contacts, BCG scar was positive in 95.3% and Mantoux test was positive in 80.66% (442/548) contacts. No contact was found falsely smear positive. The sensitivity of IgM, IgA, and IgG EIA tests was 48.7%, 25.7% and 24.4%, respectively, while the specificity was 71.5%, 80.5%, 76.6%, respectively. Performance of EIAs was not affected by the previous BCG vaccination. However, prior BCG vaccination was statistically significantly (p = 0.005) associated with Mantoux test positivity in PTB cases but not in contacts (p = 0.127). The agreement between serology and Mantoux test was not significant. Conclusion: The commercial serological test evaluated showed poor sensitivity and specificity and suggests no utility for detection of pulmonary tuberculosis [ABSTRACT FROM AUTHOR]

The indirect fluorescent antibody technique was standardised for serodiagnosis of Cryptosporidiosis in naturally infected cattle. A total of 201 faecal and serum samples were collected from different farms, animal shelters and abbatoirs in and around Bangalore which included 11 samples positive for Cryptosporidium infection on faecal microscopy. Two species viz., Cryptosporidium parvum and Cryptosporidium andersoni were prevalent based on faecal examination. Oocysts were purified by using sedimentation and gradient centrifugation and then the samples were screened by immunofluorescence antibody technique (IFAT). Out of 201 sera samples 25 samples were positive for Cryptosporidial antibodies indicating an infection rate of 12.44%. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18: 81-85 Abstract Antibody detection is a safely applied method at the wide scale in diagnosis of visceral Leishmaniasis (VL). In order to further advance serodiagnosis, the rK28 antigen has been recently introduced as a candidate for diagnosis of VL. We evaluated the sensitivity and specificity of the rK28 antigen in a micro-ELISA format in comparison to the rk39 antigen. The test was conducted on 252 parasitologically confirmed VL cases, 103 endemic healthy controls, 95 non-endemic healthy controls, 88 other infectious disease and 53 follow-up cases. Of 252 parasitologically confirmed VL cases, 251 cases were reported positive by rK28 antigen, yielding 99.6% sensitivity (95% CI, 0.97-0.99), which was similar to the sensitivity of rK39 ELISA (99.6%) (95% CI, 0.97-0.99). Specificity of the rK28 antigen in non-endemic and endemic healthy controls was 100% (95% CI 0.96-1) and 94.17% (95% CI, 0.88-0.97), respectively. In 88 different diseases, specificity was 95.45% (95% CI, 0.84-0.96). With the rK39 antigen, specificity of non-endemic and endemic controls and different diseases was 100% (95% CI 0.96-1), 92.23% (95% CI 0.85-0.96) and 96.59% (95% CI 0.90-0.98), respectively. Our results show that rK39 and rK28 antigens have similar sensitivity and specificity and rK28 can also be used as a serodiagnostic tool in the endemic population of Bihar. [ABSTRACT FROM AUTHOR]

A divide exists between categories of men who have sex with men (MSM) in India based on their sex position, which has consequences for the design of novel HIV prevention interventions. We examine the interaction between sex position and other attributes on existing HIV risk including previous HIV testing, unprotected anal intercourse (UAI), and HIV serostatus among MSM recruited from drop-in centers and public cruising areas in the twin cities of Hyderabad and Secunderabad, India. A survey was administered by trained research assistants and minimally invasive HIV testing was performed by finger-stick or oral testing. HIV seropositive MSM underwent CD4+ lymphocyte count measurement. In our sample ( n=676), 32.6% of men were married to women, 22.2% of receptive only participants were married, and 21.9% of men were HIV seropositive. In bivariate analysis, sex position was associated with previous HIV testing, UAI, HIV serostatus, and CD4+ lymphocyte count at diagnosis. In multivariate analysis with interaction terms, dual unmarried men were more likely to have undergone an HIV test than insertive unmarried men (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.2-6.5), a relationship that did not hold among married men. Conversely, dual married men were less likely than insertive married men to engage in UAI (OR 0.3; 95% CI 0.1-0.6), a relationship that did not hold among unmarried men. Further implementation research is warranted in order to best direct novel biologic and behavioral prevention interventions towards specific risk behaviors in this and other similar contexts. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the prevalence of leptospirosis among patients from within and outside Kolkata, India, attending the Calcutta School of Tropical Medicine, for treatment during August 2002 to August 2008. Methods: The leptospirosis cases were determined on the basis of clinical, epidemiological, and biochemical factors, and were tested for leptospiral antibodies using IgM ELISA. Serum samples with absorbance ratio ≥ 1.21 were interpreted as reactive. Results: The commonest presentation involved fever, headache and jaundice. The male-female ratio was 61:46. A total of 65(64.20%) cases had abnormal liver and renal functions respectively, and 57.1% had both the abnormalities. The highest incidence (75, 35.04%) was recorded in September-October followed by July-August (53, 24.77%). The reactive cases had absorbance ratios between 1.21 and 8.21, and 53 showed equivocal result, while IgM non reactivity were seen in 90 patients (absorbance ratios 0.10-0.90). The patients responded to treatment with parenteral antibiotics, penicillin, ceftriaxone and cefotaxime; follow up did not reveal case fatality. Conclusions: The cardinal signs of leptospirosis help in making clinical diagnosis, but in any hyper-endemic situation any patient reporting with acute fever and signs of pulmonary, hepatic or renal involvement should be suspected to have leptospirosis and investigated accordingly. Increased awareness, and early diagnosis and treatment, can reduce mortality due to leptospirosis. [Copyright &y& Elsevier]

Abstract: In India, the proportion of bovines vaccinated against foot-and-mouth disease (FMD) is increasing since the implementation of the Government supported ‘FMD Control Programme’, and non-structural protein (NSP)-based serological assays for discriminating between antibodies induced by infection or vaccination (DIVA) could be useful. The FMD virus NSP 3AB was expressed in a prokaryotic system and an indirect ELISA (r3AB3 I-ELISA) was developed and validated as a screening assay for detecting virus in vaccinated bovines. The diagnostic sensitivity of the assay was estimated to be 96%, while the diagnostic specificity varied between the naïve and vaccinates as 99.1% and 96.4%, respectively. This assay could detect antibodies to 3AB (3AB-Ab) from 10 to as late as 900 days post-infection in cattle infected experimentally. The “in-house” assay demonstrated higher sensitivity than a commercial 3ABC ELISA kit particularly with samples obtained from the late stages of infection. Transient post-vaccinal 3AB-Ab response could be detected in one of the three commercial vaccines during the six-month vaccination regimen, which emphasizes the fact that for a DIVA-compatible diagnostic strategy to be a realistic option, all vaccines need to be quality checked for the NSP content. [Copyright &y& Elsevier]