The performance of the SD BIOLINE Dengue DUO® rapid immunochromatographic test kit for the detection of NS1 antigen, IgM and IgG antibodies during a dengue type 1 epidemic in Jamaica.

BACKGROUND: Dengue is an important mosquito-borne viral infection that affects millions of persons worldwide. Early diagnosis is necessary to effect appropriate management and decrease mortality. Immunochromatographic tests are advantageous in producing dengue test results within 30 min but these results should be sensitive and specific. In this study we evaluated the diagnostic performance of the SD BIOLINE Dengue DUO® rapid immunochromatographic test kit. A panel of 309 dengue and 30 non-dengue single serum samples characterized by using reference enzyme-linked immunosorbent assays (ELISAs) was used. These samples were received in the virology laboratory for routine testing during a dengue type 1 outbreak between October to December, 2012. RESULTS: The overall diagnostic sensitivities of the SD BIOLINE Dengue DUO® rapid testfor IgM, IgG and NSI were 49.3% (95% CI: 41.3-57.4), 39.1% (95% CI: 33.3-45.2) and 90% (95% CI: 82.1-94.7), respectively. The IgM and IgG detection rates were significantly lower than that of the NSI (p < 0.001). However the combination of the IgM detection with NS1 detection or both NS1 and IgG resulted in a significant (p < 0.001) increase in sensitivity to 97.5% (95 % CI: 92.9-99.2) and 98.9% (95 % CI: 96.0-99.7), respectively. These higher sensitivities were achieved without any decrease in specificities. CONCLUSIONS: This study revealed that combining two or more parameters of the SD BIOLINE Dengue DUO® rapid kit significantly improved the sensitivity of diagnosis of dengue virus infection and supports its usefulness in the Jamaican setting.

An analysis of the women delivering at the community hospitals in the Northeast Region and the outcome of these deliveries

Reducing health inequities associated with poverty is an important public health concern. Most countries in expressing their commitment to primary health care and the reduction in inequity have embarked on a health reform process. This process involves the re-orientation of the health services to fit the primary health care model and bringing decision-making, planning of health policies and delivery systems closer to the people who are served by it. However developing the capability to establish reliable information systems and to analyze health status measures is a necessary adjunct to facilitate a more precise definition of sectoral priorities, improved programming, monitoring and evaluation of health programs in order to ensure a smooth transition and minimal displacement of those being served by the system. Community hospitals ... A retrospective study was carried out examining the records of women delivered at the community hospitals of the Northeast region during the period January to December 1999. A cross sectional survey of the women attending antenatal clinic at the facilities was also carried out using the hospital records and a questionnaire designed for the purpose. One third of the deliveries occuring in these facilities were found to be high risk and one of the two facilities was found to be having complication rate that is significantly higher than that of the general population. A fifth of the women are teenagers and the majority genrally of low socio economic status with very little earning potential. The majority however lived ... Which may explain their preference for using these facilities in spite of their risk status. Stricter attention should be paid to the women being admitted for delivery at community hospitals and a more liberal referral policy be adopted though it is noted that a significant number of high risk cases present to community hospital at a point in labour where time might not afford effective transfer. The community hospitals should therefore be equipped with basic resuscitation equipment inclusive of even one incubator for use while the compromised baby awaits transfer, and the nursing sraff and midwives under go frequent refresher courses re the management of common obstetric complications. A doctor should also be available on call on a twenty-four hour basis (AU)