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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Enhanced diagnosis of pneumococcal meningitis with use of the binax NOW immunochromatographic test of Streptococcus pneumoniae antigen: A multisite study
Clinical Infectious Diseases, Volume 48, No. SUPPL. 2, Year 2009
Notification
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Description
Background. Accurate etiological diagnosis of meningitis in developing countries is needed, to improve clinical care and to optimize disease-prevention strategies. Cerebrospinal fluid (CSF) culture and latex agglutination testing are currently the standard diagnostic methods but lack sensitivity. Methods. We prospectively assessed the utility of an immunochromatographic test (ICT) of pneumococcal antigen (NOW Streptococcus pneumoniae Antigen Test; Binax), compared with culture, in 5 countries that are conducting bacterial meningitis surveillance in Africa and Asia. Most CSF samples were collected from patients aged 1-59 months. Results. A total of 1173 CSF samples from suspected meningitis cases were included. The ICT results were positive for 68 (99%) of the 69 culture-confirmed pneumococcal meningitis cases and negative for 124 (99%) of 125 culture-confirmed bacterial meningitis cases caused by other pathogens. By use of culture and latex agglutination testing alone, pneumococci were detected in samples from 7.4% of patients in Asia and 15.6% in Africa. The ICT increased pneumococcal detection, resulting in similar identification rates across sites, ranging from 16.2% in Nigeria to 20% in Bangladesh. ICT detection in specimens from culture-negative cases varied according to region (8.5% in Africa vs. 18.8% in Asia; P <.001), prior antibiotic use (24.2% with prior antibiotic use vs. 12.2% without; P <.001), and WBC count (9.0% for WBC count of 10-99 cells/mL, 22.1% for 100-999 cells/mL, and 25.4% for ≥1000 cells/mL; P <.001 by test for trend). Conclusions. The ICT provided substantial benefit over the latex agglutination test and culture at Asian sites but not at African sites. With the addition of the ICT, the proportion of meningitis cases attributable to pneumococci was determined to be similar in Asia and Africa. These results suggest that previous studies have underestimated the proportion of pediatric bacterial meningitis cases caused by pneumococci. © 2009 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Moïsi, Jennifer C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Saha, Samir Kumar
Unknown Affiliation
Falade, Adegoke Gbadegesin
Unknown Affiliation
Njanpop-Lafourcade, Berthe Marie
Unknown Affiliation
Zaidi, Anita Kaniz Mehdi
Unknown Affiliation
Bakare, Rasheed Ajani
Unknown Affiliation
Lasi, Razzaq
Unknown Affiliation
Mueller, Judith E.
Unknown Affiliation
Odekanmi, A. A.
Unknown Affiliation
Sangaré, Lassana
Unknown Affiliation
Scott, John Anthony Gerard
Unknown Affiliation
Deloria Knoll, Maria
Unknown Affiliation
Levine, Orin S.
Unknown Affiliation
Gessner, Bradford D.
Unknown Affiliation
Statistics
Citations: 77
Authors: 14
Affiliations: 1
Identifiers
Doi:
10.1086/596481
ISSN:
10584838
Study Locations
Nigeria