Rabies diagnosis for developing countries.
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 diagnos...
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ftdoajarticles:oai:doaj.org/article:83d6b9f6c13844c7ba66c3b053922aaf 2023-05-15T15:18:17+02:00 Rabies diagnosis for developing countries. Salome Dürr Service Naïssengar Rolande Mindekem Colette Diguimbye Michael Niezgoda Ivan Kuzmin Charles E Rupprecht Jakob Zinsstag 2008-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000206 https://doaj.org/article/83d6b9f6c13844c7ba66c3b053922aaf EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2268742?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000206 https://doaj.org/article/83d6b9f6c13844c7ba66c3b053922aaf PLoS Neglected Tropical Diseases, Vol 2, Iss 3, p e206 (2008) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2008 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000206 2022-12-31T00:38:41Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 2 3 e206 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Salome Dürr Service Naïssengar Rolande Mindekem Colette Diguimbye Michael Niezgoda Ivan Kuzmin Charles E Rupprecht Jakob Zinsstag Rabies diagnosis for developing countries. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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. |
format |
Article in Journal/Newspaper |
author |
Salome Dürr Service Naïssengar Rolande Mindekem Colette Diguimbye Michael Niezgoda Ivan Kuzmin Charles E Rupprecht Jakob Zinsstag |
author_facet |
Salome Dürr Service Naïssengar Rolande Mindekem Colette Diguimbye Michael Niezgoda Ivan Kuzmin Charles E Rupprecht Jakob Zinsstag |
author_sort |
Salome Dürr |
title |
Rabies diagnosis for developing countries. |
title_short |
Rabies diagnosis for developing countries. |
title_full |
Rabies diagnosis for developing countries. |
title_fullStr |
Rabies diagnosis for developing countries. |
title_full_unstemmed |
Rabies diagnosis for developing countries. |
title_sort |
rabies diagnosis for developing countries. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2008 |
url |
https://doi.org/10.1371/journal.pntd.0000206 https://doaj.org/article/83d6b9f6c13844c7ba66c3b053922aaf |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 2, Iss 3, p e206 (2008) |
op_relation |
http://europepmc.org/articles/PMC2268742?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000206 https://doaj.org/article/83d6b9f6c13844c7ba66c3b053922aaf |
op_doi |
https://doi.org/10.1371/journal.pntd.0000206 |
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PLoS Neglected Tropical Diseases |
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2 |
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3 |
container_start_page |
e206 |
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1766348484913397760 |