Rapid and Simple Paper Diagnostic Test to Detect Enteric Pathogens in the Developing World

项目摘要 根据世界卫生组织的数据，每年有17亿例肠胃炎病例， 每年约有150万儿童死亡。腹泻病是第二大 五岁以下儿童的死亡原因，主要是在发展中国家。宽范围 细菌、病毒和寄生虫病原体的混合感染可引起疾病， 在疾病负担高的低收入国家。资源中治疗的临床确定- 有限的保健设置经常在没有病因学知识的情况下进行。因此，在本发明中， 抗生素处方过多，针对性差，病原体引起的感染， 高死亡率可能得不到适当质量的护理。诊断测试这些 病原体是不一致的，因为这些常见病原体的检测传统上需要 将患者或患者样本运送到有限数量的 诊断实验室，然后进行跨微生物学，病毒学， 分子实验室结果可能在几天内无法获得，在此期间， 如果不进行适当的治疗，病情可能会恶化。病原体的快速鉴定 在护理点引起感染性腹泻疾病的病毒可以挽救生命并改善健康 通过及时和适当的治疗。发展中国家的潜在用户 世界可包括农村地区或城市低收入低健康人群的三级诊所 护理利用率和调查疫情的国家公共卫生现场官员。的目标 我们的项目是确定开发一种创新的试纸条测试的可行性， 将低成本、简单的粪便样品制备和浓缩方法的步骤结合起来， 用多重核酸捕获总核酸中空二氧化硅微球 在纸条装置上进行放大和检测。我们将测试600个病人的粪便样本 参加了一项正在孟加拉国低收入社区进行的胃肠道疾病研究， 霍乱、沙门氏菌、志贺氏菌、弯曲杆菌等病原体感染的流行率 高这个项目的成功可以在其他简单的发展产生广泛的影响，点- 在其他样本类型中对引起其他疾病的病原体进行即时鉴别检测。

Project Summary According to the World Health Organization, there are 1.7 billion cases of gastroenteritis every year and approximately 1.5 million children deaths. Diarrheal disease is the second leading cause of death in children under five years of age, mostly in the developing world. A wide-range of bacterial, viral, and parasitic pathogens can cause disease, with co-infections being common in low income countries with high disease burden. Clinical determination of therapy in resource- limited healthcare settings is frequently performed without etiological knowledge. As a result, antibiotics are overprescribed and poorly targeted, and infections caused by pathogens with high mortality rates may not be given adequate quality of care. Diagnostic testing for these pathogens is inconsistent because detection of these common pathogens traditionally requires transporting patients or patient samples, possibly over long distances, to a limited number of diagnostic laboratories, and then performing multiple tests across microbiology, virology, and molecular laboratories. Results may not be available for several days during which patients’ conditions may deteriorate without appropriate treatment. The rapid identification of pathogens that cause infectious diarrheal disease at the point-of-care may save lives and improve health outcomes by enabling prompt and appropriate treatment. Potential users in the developing world could include tertiary clinics in rural areas or urban low-income populations with low health care utilization and national public health field officers who investigate outbreaks. The goal of our project is to determine the feasibility of developing an innovative paper strip test that can integrate the steps of low cost, simple stool sample preparation and concentration method using hollow silica microspheres for total nucleic acid capture with multiplexed nucleic acid amplification and detection on a paper strip device. We will test 600 stool samples from patients enrolled in an ongoing study of GI disease in low-income neighborhoods of Bangladesh where the prevalence of infection by pathogens like Cholera, Salmonella, Shigella, Campylobacter is high. Success in this project can have broad impact in the development of other simple, point- of-care differential detection tests for pathogens causing other diseases in other sample types.