Investigation of a measles outbreak in Zimbabwe, 2010: potential of a point of care test to replace laboratory confirmation of suspected cases
Investigation of a measles outbreak in Zimbabwe, 2010: potential of a point of care test to replace laboratory confirmation of suspected cases
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DOI：
10.1017/s0950268815000540
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发表时间：
2015-12-01
影响因子：
4.2
通讯作者：
Samuel, D.
中科院分区：
文献类型：
--
作者：
Shonhai, A.;Warrener, L.;Samuel, D.
2010年2月至11月，在津巴布韦全国范围的麻疹疫情期间，从103例疑似麻疹病例中采集了血液和口腔液（OF）样本。应用西门子麻疹IgM酶免疫分析（EIA）、麻疹IgM捕捉酶免疫分析（EIA）、实时荧光定量PCR（PCR）和巢式核衣壳（N）基因检测，确诊麻疹病例75例。然后，这些样本被用于评估新开发的麻疹护理点测试（POCT），并确定其在疫情中识别麻疹病例的潜力。在对OF样本进行POCT后，从使用的试纸条中提取核酸，并通过RT-PCR扩增麻疹H和N基因。POCT检测OF IgM的敏感性、特异性、阳性和阴性预测值分别为75.0% [95% CI 63.4-84.5]、96.2%（95% CI 80.4-99.9）、98.2%（95% CI 90.3-100）和58.1%（95% CI 42.1-73.0）。N基因序列显示原始OF和相应POCT条带之间的高度一致性。所有病例均为B3基因型。我们的结论是，麻疹POCT有可能被用于，在接触点，在爆发的情况下，并提供病毒的分子特征在以后的日期。
Blood and oral fluid (OF) samples were collected from 103 suspected measles cases between February and November 2010 during a nationwide measles outbreak in Zimbabwe. Siemens measles IgM enzyme immunoassay (EIA) on serum, Microimmune measles IgM capture EIA on OF, real-time haemagglutinin (H) gene PCR and nested nucleocapsid (N) gene PCR on OF were performed, confirming 75 measles cases. These samples were then used to evaluate a newly developed point of care test (POCT) for measles and determine its potential for identifying measles cases in outbreaks. After performing POCTs on OF samples, nucleic acid was extracted from the used test strips and the measles H and N genes amplified by RT-PCR. The sensitivity, specificity, positive and negative predictive values of the POCT for IgM in OF was 75.0% [95% confidence interval (CI) 63.4-84.5], 96.2% (95% CI 80.4-99.9), 98.2% (95% CI 90.3-100) and 58.1% (95% CI 42.1-73.0), respectively. The N gene sequences showed high level of agreement between original OF and corresponding POCT strips. Measles genotype B3 was identified in all cases. We conclude that the measles POCT has the potential to be used, at the point of contact, in outbreak situations and provide molecular characterization of the virus at a later date.