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Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children

Antimicrobials are only indicated in acute childhood diarrhea if it is invasive or persistent. Rapid screening for invasive diarrhea can therefore inform treatment decisions but pathogen identification by culture is slow, expensive and cumbersome. This study aimed to assess the diagnostic utility of...

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Autores principales: Kwasi, David A., Adewole, Pelumi D., Akinlabi, Olabisi C., Ekpo, Stella E., Okeke, Iruka N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358913/
https://www.ncbi.nlm.nih.gov/pubmed/37471343
http://dx.doi.org/10.1371/journal.pgph.0001629
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author Kwasi, David A.
Adewole, Pelumi D.
Akinlabi, Olabisi C.
Ekpo, Stella E.
Okeke, Iruka N.
author_facet Kwasi, David A.
Adewole, Pelumi D.
Akinlabi, Olabisi C.
Ekpo, Stella E.
Okeke, Iruka N.
author_sort Kwasi, David A.
collection PubMed
description Antimicrobials are only indicated in acute childhood diarrhea if it is invasive or persistent. Rapid screening for invasive diarrhea can therefore inform treatment decisions but pathogen identification by culture is slow, expensive and cumbersome. This study aimed to assess the diagnostic utility of stool microscopy and immunochromatographic fecal occult blood test (FOBT) kits for identifying invasive or potentially invasive diarrhea in Ibadan, Nigeria. Fecal specimens from 46 children under 5 years old with diarrhea, collected as part of ongoing case-control studies, were subjected to stool microscopy for erythrocytes and leucocytes, and FOBT using the innovator’s product and four locally procurable generic immunochromatographic kits, each according to manufacturers’ instructions. Stool specimens were cultured for enteric bacterial pathogens using standard procedures. Presumptive pathogen isolates were identified biochemically and by PCR, and then confirmed by whole genome sequencing. Shigella, enteroinvasive Escherichia coli and Yersinia, pathogens that invariably cause invasive diarrhea, were detected in five of 46 specimens. Occult blood detection by microscopy was 55.6% sensitive and 78.4% specific, while the innovator’s FOBT product was respectively 62.5% and 81.6% sensitive and specific compared to strict invasive pathogen recovery. Microscopy and FOBT testing were less sensitive in identifying specimens that contained pathogens that do not always elicit invasive diarrhea. Generic FOBT tests compared well with the innovator’s product. Microscopy and FOBT testing have some value for delineating likely invasive diarrheas. They could inform treatment and serve as early warning indicators for dysentery outbreaks in resource limited settings. Inexpensive, generic FOBT kits that are locally procurable in Nigeria performed as well as the innovator’s product.
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spelling pubmed-103589132023-07-21 Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children Kwasi, David A. Adewole, Pelumi D. Akinlabi, Olabisi C. Ekpo, Stella E. Okeke, Iruka N. PLOS Glob Public Health Research Article Antimicrobials are only indicated in acute childhood diarrhea if it is invasive or persistent. Rapid screening for invasive diarrhea can therefore inform treatment decisions but pathogen identification by culture is slow, expensive and cumbersome. This study aimed to assess the diagnostic utility of stool microscopy and immunochromatographic fecal occult blood test (FOBT) kits for identifying invasive or potentially invasive diarrhea in Ibadan, Nigeria. Fecal specimens from 46 children under 5 years old with diarrhea, collected as part of ongoing case-control studies, were subjected to stool microscopy for erythrocytes and leucocytes, and FOBT using the innovator’s product and four locally procurable generic immunochromatographic kits, each according to manufacturers’ instructions. Stool specimens were cultured for enteric bacterial pathogens using standard procedures. Presumptive pathogen isolates were identified biochemically and by PCR, and then confirmed by whole genome sequencing. Shigella, enteroinvasive Escherichia coli and Yersinia, pathogens that invariably cause invasive diarrhea, were detected in five of 46 specimens. Occult blood detection by microscopy was 55.6% sensitive and 78.4% specific, while the innovator’s FOBT product was respectively 62.5% and 81.6% sensitive and specific compared to strict invasive pathogen recovery. Microscopy and FOBT testing were less sensitive in identifying specimens that contained pathogens that do not always elicit invasive diarrhea. Generic FOBT tests compared well with the innovator’s product. Microscopy and FOBT testing have some value for delineating likely invasive diarrheas. They could inform treatment and serve as early warning indicators for dysentery outbreaks in resource limited settings. Inexpensive, generic FOBT kits that are locally procurable in Nigeria performed as well as the innovator’s product. Public Library of Science 2023-07-20 /pmc/articles/PMC10358913/ /pubmed/37471343 http://dx.doi.org/10.1371/journal.pgph.0001629 Text en © 2023 Kwasi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kwasi, David A.
Adewole, Pelumi D.
Akinlabi, Olabisi C.
Ekpo, Stella E.
Okeke, Iruka N.
Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title_full Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title_fullStr Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title_full_unstemmed Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title_short Evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
title_sort evaluation of fecal occult blood testing for rapid diagnosis of invasive diarrhea in young children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358913/
https://www.ncbi.nlm.nih.gov/pubmed/37471343
http://dx.doi.org/10.1371/journal.pgph.0001629
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