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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Quantitative PCR for detection of Shigella improves ascertainment of Shigella burden in children with moderate-to-severe diarrhea in low-income countries
Journal of Clinical Microbiology, Volume 51, No. 6, Year 2013
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Description
Estimates of the prevalence of Shigella spp. are limited by the suboptimal sensitivity of current diagnostic and surveillance methods. We used a quantitative PCR (qPCR) assay to detect Shigella in the stool samples of 3,533 children aged <59 months from the Gambia, Mali, Kenya, and Bangladesh, with or without moderate-to-severe diarrhea (MSD). We compared the results from conventional culture to those from qPCR for the Shigella ipaH gene. Using MSD as the reference standard, we determined the optimal cutpoint to be 2.9 × 104 ipaH copies per 100 ng of stool DNA for set 1 (n = 877). One hundred fifty-eight (18%) specimens yielded >2.9 × 104 ipaH copies. Ninety (10%) specimens were positive by traditional culture for Shigella. Individuals with ≥2.9 × 104 ipaH copies have 5.6-times-higher odds of having diarrhea than those with <2.9 × 10 4 ipaH copies (95% confidence interval, 3.7 to 8.5; P < 0.0001). Nearly identical results were found using an independent set of samples. qPCR detected 155 additional MSD cases with high copy numbers of ipaH, a 90% increase from the 172 cases detected by culture in both samples. Among a subset (n = 2,874) comprising MSD cases and their age-, gender-, and location-matched controls, the fraction of MSD cases that were attributable to Shigella infection increased from 9.6% (n = 129) for culture to 17.6% (n = 262) for qPCR when employing our cutpoint. We suggest that qPCR with a cutpoint of approximately 1.4 × 104 ipaH copies be the new reference standard for the detection and diagnosis of shigellosis in children in low-income countries. The acceptance of this new standard would substantially increase the fraction of MSD cases that are attributable to Shigella. Copyright © 2013, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Lindsay, Brianna R.
United States, Baltimore
University of Maryland School of Medicine
Ochieng, John Benjamin
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
Ikumapayi, Usman Nurudeen A.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Touré, Aliou Y.
Mali, Bamako
Centre Pour le Développement Des Vaccins Cvd-mali
Ahmed, Dilruba
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Li, Shan
United States, Baltimore
University of Maryland School of Medicine
Panchalingam, Sandra
United States, Baltimore
University of Maryland School of Medicine
Levine, Myron M.
United States, Baltimore
University of Maryland School of Medicine
Kotloff, Karen L.
United States, Baltimore
University of Maryland School of Medicine
Rasko, David A.
United States, Baltimore
University of Maryland School of Medicine
Morris, Carolyn R.
United States, Baltimore
University of Maryland School of Medicine
Juma, Jane
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
Fields, Barry S.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
Dione, Michel Maïnack
Gambia, Banjul
Medical Research Council Laboratories Gambia
Malle, Dramane
Mali, Bamako
Centre Pour le Développement Des Vaccins Cvd-mali
Becker, Stephen M.
United States, Charlottesville
University of Virginia School of Medicine
Houpt, Eric R.
United States, Charlottesville
University of Virginia School of Medicine
Nataro, James Paul
United States, Charlottesville
University of Virginia School of Medicine
Sommerfelt, Halvor
Norway, Bergen
Universitetet I Bergen
Pop, Mihai
United States, College Park
University of Maryland, College Park
Oundo, Joseph Wang Ang’a A.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
Antonio, Martin
Gambia, Banjul
Medical Research Council Laboratories Gambia
Hossain, Anowar K.M.Tanvir
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Tamboura, Boubou
Mali, Bamako
Centre Pour le Développement Des Vaccins Cvd-mali
Stine, Oscar Colin
United States, Baltimore
University of Maryland School of Medicine
Statistics
Citations: 105
Authors: 25
Affiliations: 8
Identifiers
Doi:
10.1128/JCM.02713-12
ISSN:
00951137
e-ISSN:
1098660X
Research Areas
Genetics And Genomics
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Gambia
Kenya
Mali