Rabies diagnosis for developing countries.

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Rabies diagnosis for developing countries. Abstract Text:

Salome ,Service ,Rolande Mindekem,Colette Diguimbye,Michael Niezgoda,Ivan Kuzmin,Charles E Rupprecht,Jakob Zinsstag,

BACKGROUND: Canine rabies is a neglected disease causing 55,000 human deaths worldwide per year, and 99% of all cases are transmitted by dog bites. In N'Djaména, the capital of Chad, rabies is endemic with an incidence of 1.71/1,000 dogs (95% C.I. 1.45-1.98). The gold standard of rabies diagnosis is the direct immunofluorescent antibody (DFA) test, requiring a fluorescent microscope. The Centers for Disease Control and Prevention (CDC, Atlanta, United States of America) developed a histochemical test using low-cost light microscopy, the direct rapid immunohistochemical test (dRIT). METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the dRIT in the Chadian National Veterinary Laboratory in N'Djaména by testing 35 fresh samples parallel with both the DFA and dRIT. Additional retests (n = 68 in Chad, n = 74 at CDC) by DFA and dRIT of stored samples enhanced the power of the evaluation. All samples were from dogs, cats, and in one case from a bat. The dRIT performed very well compared to DFA. We found a 100% agreement of the dRIT and DFA in fresh samples (n = 35). Results of retesting at CDC and in Chad depended on the condition of samples. When the sample was in good condition (fresh brain tissue), we found simple Cohen's kappa coefficient related to the DFA diagnostic results in fresh tissue of 0.87 (95% C.I. 0.63-1) up to 1. For poor quality samples, the kappa values were between 0.13 (95% C.I. -0.15-0.40) and 0.48 (95% C.I. 0.14-0.82). For samples stored in glycerol, dRIT results were more likely to agree with DFA testing in fresh samples than the DFA retesting. CONCLUSION/SIGNIFICANCE: The dRIT is as reliable a diagnostic method as the gold standard (DFA) for fresh samples. It has an advantage of requiring only light microscopy, which is 10 times less expensive than a fluorescence microscope. Reduced cost suggests high potential for making rabies diagnosis available in other cities and rural areas of Africa for large populations for which a capacity for diagnosis will contribute to rabies control.

Rabies diagnosis for developing countries. Publishing Authors By Initials

S ,S ,R Mindekem,C Diguimbye,M Niezgoda,I Kuzmin,CE Rupprecht,J Zinsstag,

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Rabies diagnosis for developing countries. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: PLoS neglected tropical diseases

VOLUME: 2

Page Numbers: e206

Journal Abbreviation: PLoS Negl Trop Dis

ISSN: 1935-2735

DAY: 26

MONTH: 03

YEAR: 2008

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LANGUAGE: eng

NlmUniqueID: 101291488

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AFFILIATION: Swiss Tropical Institute, Basel, Switzerland.

Country: United States

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MEDLINETA: PLoS Negl Trop Dis

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