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Evaluación de campo de un test diagnóstico rápido para meningitis meningocócica en Níger
Author(s) -
Boisier P.,
Elhaj Mahamane A.,
Amadou Hamidou A.,
Sidikou F.,
Djibo S.,
Nato F.,
Chanteau S.
Publication year - 2009
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2008.02192.x
Subject(s) - medicine , dipstick , concordance , vaccination , meningitis , kappa , cohen's kappa , diagnostic test , rapid diagnostic test , virology , pediatrics , urine , linguistics , philosophy , machine learning , computer science
Summary Objective To evaluate dipstick rapid diagnostic tests (RDTs) for meningococcal meningitis in basic health facilities. Methods Health facility staff received a one‐day training. During the meningitis season, they performed RDTs on cerebrospinal fluid (CSF) specimens from suspected cases of meningitis. A frozen aliquot of CSF was later tested using polymerase chain reaction (PCR) to establish the reference diagnosis. RDTs used in health facilities were archived to allow checking the concordance between reported diagnosis and observed results. Reported diagnosis was also compared to PCR diagnosis. A second RDT was performed on each CSF specimen at the reference laboratory. Results Using RDTs, health facilities reported 382 negative results (73.9%), 114 NmA (22.1%), 12 NmW135 (2.3%) and nine uninterpretable results (1.7%), the latter corresponding to the misuse of a reagent by three agents. The agreement between reported diagnosis and archived dipsticks was excellent (kappa = 0.98). The agreement between PCR diagnosis and reported RDTs results was strong (kappa = 0.82). In health facilities, the sensitivity of RDTs for N. meningitidis A was Se = 0.91. The kappa coefficient measuring the agreement between RDTs operated in the reference laboratory and RDTs operated in health facilities was κ = 0.78. Conclusion We confirmed that dipstick RDTs to identify N. meningitidis serogroups A, C, W135 and Y can be reliably operated by non‐specialized staff in basic health facilities. RDTs proved very useful to recommend vaccination in NmA epidemics, and also to avoid vaccination in epidemics due to serogroups not included in vaccines (NmX).