A clinic-based direct real-time fluorescent reverse transcription loop-mediated isothermal amplification assay for influenza virus.

Seasonal influenza virus causes acute respiratory tract infections, which can be severe in children and the elderly. At present, rapid influenza diagnostic tests (RIDTs) are popular at clinical sites because they enable early diagnosis and avoid unnecessary use of antibiotics; in addition, high risk patients with underlying disease can be given antiviral drugs. However, the sensitivity and specificity of some of those tests are relatively poor. To overcome these problems, nucleic acid-based molecular point-of-care tests have been developed; however, they are significantly more expensive than RIDTs. Previously, the authors developed real-time reverse transcription loop-mediated isothermal amplification (rRT-LAMP) assays using a quenching primer to detect influenza viruses. However, the assay is limited to laboratory use because it requires a nucleic acid purification step and preparation of reaction mixtures on ice. Therefore, the authors developed and validated direct rRT-LAMP assays that require no nucleic acid purification steps using commercial RNA isolation kits, and no storage and handling of reagents on ice. These assays can be performed within 10-30 min and require only mixing a clinical specimen with extraction reagent followed by addition of a lyophilized detection reagent. The established assay showed high sensitivity and specificity when validated using 310 clinical specimens. Thus, the assay is a powerful tool for molecular diagnosis of seasonal influenza virus infection in the clinic.

Impact of education and network for avian influenza H5N1 in human: knowledge, clinical practice, and motivation on medical providers in Vietnam.

BACKGROUND: Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. METHODS/PRINCIPAL FINDINGS: Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. CONCLUSIONS: Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality.

Survey-based cancer mortality in the Lao PDR, 2007-08.

BACKGROUND: The Lao PDR is a landlocked country with 5,920,000 inhabitants for which very few epidemiological studies on cancer have been performed. The aim of the present study was to examine cancer mortality in 2007-2008. METHODS: A descriptive cancer epidemiology protocol was designed with a data collection form and guideline for both demographics and list of all deaths from all 757 local Health Centers of 17 provinces/ cities. Five indicators, name, age, sex, date of death and the cause of death (ICD-10), were collected for each case. The age-specific cancer mortality rate and ASRs per 100,000 were estimated. RESULTS: There were 448 cancer cases reported from Health Centers within 7 of 17 provinces/cities. Number of person-years was 654,459 for the two-year period. Cancer mortality rates of all sites (ASR) were 116.7 and 97.2 per 100,000 in males and females, respectively. The five most common cancers causing mortality per 100,000 were liver (52.2), followed by colorectal (19.0), lung (17.3), stomach (6.9), and leukemia-lymphoma (7.2) in males and liver (28.4); followed by colorectal (19.0), lung (14.0), cervical uteri (9.2) and stomach (7.1) in females. CONCLUSIONS: Liver and colorectal cancers were the first and second most common, respectively, in both males and female.