Evaluation of seroprevalence of Hepatitis B virus infection among patients attending a hospital of semi-urban North India using rapid immunoassay test.

BACKGROUND: Viral hepatitis is a serious public health problem with hepatitis B virus (HBV) being one of its principle causes affecting billions of people globally. The laboratory diagnosis of HBV infection is made by detection of hepatitis B surface antigen (HBsAg) in serum. OBJECTIVE: The present study was done to evaluate the seroprevalence of hepatitis B infection among patients attending a hospital at a semi-urban North India using rapid immunoassay test kit. MATERIALS AND METHODS: A total of 1537 patients were included in the study whose venous blood samples were collected, and serum was tested for the presence of HBsAg using a rapid one-step immunoassay test kit. RESULTS: Out of 1537 patients whose blood samples were tested, 61 were found to be reactive to HBsAg giving the prevalence to be 3.9%, with 49 males and 12 females. Out of 61 reactive patient's majority belonged to inpatient (82.0%) as compared to outpatient department (18.0%). The majority of the reactive patients belonged to age group 28-37 years (37.7%), belonged to rural areas (86.9%), were illiterate (67.2%), were skilled workers (63.9%) and belonged to socioeconomic Class 4 (50.8%). Among the reactive patients, the most frequent suspected risk factor for hepatitis B infection was found to be visiting a community barber (19.7%). CONCLUSION: HBV infection is a dreadful disease, and its accurate and timely diagnosis using rapid immunoassay test kit is useful as it gives an indication about its seroprevalence in a given geographical area even with limited resources.

Comparison of four diagnostic techniques for detection of Trichomonas vaginalis infection in females attending tertiary care hospital of North India.

BACKGROUND: Trichomonas vaginalis causes a common sexually transmitted disease trichomoniasis, which may lead to increased risk of transmission of human immunodeficiency virus infection and other pelvic inflammatory diseases. Wet mount examination is the most common test for diagnosis, but it has low sensitivity. Acridine orange staining can be used for diagnosis, but it requires special microscopic facility. Culture is considered as the gold standard, but it takes a long time for diagnosis. OSOM Trichomonas Rapid Test is a recently introduced rapid method based on immunochromatographic assay of trichomonal protein antigens. Hence, the present study was done to compare these four diagnostic techniques for detection of trichomoniasis in females with vaginal discharge. MATERIALS AND METHODS: Vaginal swabs were taken from 835 female patients and wet mount examination, acridine orange staining, culture in Kupferberg medium, and OSOM Trichomonas Rapid Test, were performed. RESULTS: Out of 835 patients included in our study, 68 (8.1%) positive cases of trichomoniasis were detected by culture. OSOM Trichomonas Rapid Test detected 63 (7.5%) cases, acridine orange staining detected 53 (6.3%) cases, whereas, wet mount examination detected only 45 (5.4%) positive cases. OSOM Trichomonas Rapid Test performed well and showed high sensitivity and specificity of 88.2% and 99.6%, respectively. CONCLUSION: As OSOM Trichomonas Rapid Test is a point of care test and gave better results than both wet mount examination and acridine orange staining; it can be used as a routine test in peripheral areas lacking laboratory facilities.

A Comparison of Microscopy and Enzyme Linked Immunosorbent Assay for Diagnosis of Giardia lamblia in Human Faecal Specimens.

BACKGROUND: Giardia lamblia, a flagellate protozoa, is a common causative agent of parasitic diarrhoeal diseases of humans. Laboratory diagnosis mainly consists of direct microscopic examination of stool specimen for trophozoite and cysts of Giardia. However, due to intermittent faecal excretion of parasite, the case may be miss diagnosed and the patient may continue excreting the parasite and infecting others. Therefore, other mode of diagnosis should be looked for, which overcome the above drawbacks of microscopy used alone for diagnosis. OBJECTIVES: The present study was done to evaluate the efficacy of RIDASCREEN Giardia (ELISA) test in comparison to direct microscopy in the diagnosis of Giardia lamblia in stool specimens from patients with diarrhea and other gastrointestinal symptoms. MATERIALS AND METHODS: A total of 1680 patients were included in the study and three faecal specimens were taken from each patient which was divided into two parts. One part was used for direct wet mount examination and second part was used to put ELISA by using RIDASCREEN Giardia test. RESULTS: Out of 1680 stool samples, 380 specimens (22.6%) were found to be positive for Giardia lamblia. Maximum cases were detected by RIDASCREEN Giardia (ELISA) test with sensitivity of 100% and specificity of 91.5%. Maximum cases of giardiasis were detected in children less than 10 y of age (12.8%). CONCLUSION: RIDASCREEN Giardia test is a rapid and effective method with high sensitivity and specificity and detects Giardia antigens in stool specimens even when the count of parasite is low, thus reducing the chances of missing even the asymptomatic cases.

Evaluation of Different Staining Techniques in the Diagnosis of Trichomonas vaginalis Infection in Females of Reproductive Age Group.

BACKGROUND: Trichomonas vaginalis is a parasitic protozoan which causes most common non viral sexually transmitted disease trichomoniasis. Direct microscopic examination of vaginal fluid remains the most widely used diagnostic test. Although, wet mount examination is the most cost-effective diagnostic test, but it has low sensitivity resulting in under diagnosis of the disease. Therefore, to overcome this problem, various staining techniques like giemsa and acridine orange can be used along with wet mount examination for diagnosis of T. vaginalis infection. OBJECTIVE: The present study was done to evaluate the efficacy of Giemsa and Acridine Orange staining in comparison with wet mount examination for the diagnosis of vaginal trichomoniasis. MATERIALS AND METHODS: A total of 615 female patients of reproductive age group having vaginal discharge were included in the study and swabs containing vaginal fluids were taken to perform wet mount examination, giemsa staining and acridine orange staining. RESULT: Trichomonas vaginalis infection was detected in 37 patients with maximum cases (6.0%) detected by acridine orange staining, followed by giemsa staining (4.9%), whereas, wet mount examination was able to detect only 4.1% cases. Wet mount examination gave a sensitivity of 67.6%, whereas, the sensitivity of giemsa staining and acridine orange staining was found to be 80% and 100% respectively. CONCLUSION: Since the performance of both the staining techniques was found to be much better in comparison to wet mount examination, and they also detected several wet mount negative cases, they should be used as an adjunct to wet mount examination. This will also be beneficial to the overall health of the patient by early diagnosis and treatment of cases, thereby, reducing the development of associated morbidity.