Innovative Testing Strategies for the Diagnosis of Syphilis


Book Description

Traditional serological syphilis testing in the US currently includes screening with a nontreponemal assay that detects antibodies to lipoidal material released into the blood from host cells damaged by Treponema pallidum as well as lipids on the surface of nonspecific treponemes itself. Reactive nontreponemal tests are subsequently confirmed with a test that detects antibody specific for T. pallidum (termed "treponemal"). It has been suggested that this traditional serological algorithm could be reversed so that screening begins with a treponemal test, such as an enzyme immunoassay (EIA), and if reactive, infection would be confirmed with a nontreponemal test. In cases of discordance between the screening treponemal test and the confirmatory non-treponemal test, the CDC suggests that a second treponemal test (such as a TPPA) could be utilized to serve as a supplemental test. The reverse sequence testing algorithm offers several advantages over the traditional algorithm for laboratories. Screening with an immunoassay (IA) (1) allows for the use of automation, thus potentially increasing laboratory efficiency; (2) provides objective instead of subjective results; (3) reduces the amount of manual manipulation that is involved with nontreponemal assays. However, the algorithm is not without issues. Perhaps greatest amongst them is that such tests will be reactive in cases where the patient has previously been treated for syphilis. This may be particularly problematic in a setting with a high prevalence of syphilis where many patients being tested may have had a previous case of the disease. This dissertation is formatted as three individual, self-contained reports of research investigations with an overall introduction and conclusion. Chapter 2 reports on the performance of a reverse sequence algorithm in San Francisco and shows that this algorithm would cause a large amount of additional work for the laboratory. Chapter 3 describes a reduction in the number of supplemental treponemal tests that needs to be run if EIA signal-to-cutoff ratios were considered as part of the algorithm. Chapter 4 describes how a rapid syphilis test could potentially replace the TPPA as the second supplemental test in the reverse sequence algorithm, thus decreasing the turnaround time to report positive syphilis results.




The Use of Rapid Syphilis Tests


Book Description

This manual provides a general overview on the use of rapid syphilis tests, their purchase, transport and storage.--Publisher's description.







Sexually Transmitted Infections


Book Description

One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.










Syphilis


Book Description

Syphilis, a sexually transmitted disease was first described in 15th century, is caused by Treponema pallidum subsp. pallidum and occurs worldwide. This book is a collection of chapters presenting the novel knowledge about the T. pallidum and some historical and up to date information about venereal disease and syphilis. The collection of articles includes: immunological aspects recognition of T. pallidum by the pattern recognition receptors of the innate immune; the whole genome analysis of treponemes and new targets for its molecular diagnosis; some historical aspects of venereal diseases treatment; natural history of syphilis including clinical manifestation and epidemiology; a clinical aspects dealing with psychiatric manifestations of neurosyphilis; spatial and temporal patterns of primary syphilis and secondary syphilis described by the spatial and space-time scan statistics; a commonly used methods for laboratorial diagnosis, the serological response to treatment of syphilis and safety in blood transfusion. I hope this book will be useful for students and research fellows as well for the wide audience.




Revolutionizing Tropical Medicine


Book Description

A comprehensive resource describing innovative technologies and digital health tools that can revolutionize the delivery of health care in low- to middle-income countries, particularly in remote rural impoverished communities Revolutionizing Tropical Medicine offers an up-to-date guide for healthcare and other professionals working in low-resource countries where access to health care facilities for diagnosis and treatment is challenging. Rather than suggesting the expensive solution of building new bricks and mortar clinics and hospitals and increasing the number of doctors and nurses in these deprived areas, the authors propose a complete change of mindset. They outline a number of ideas for improving healthcare including rapid diagnostic testing for infectious and non-infectious diseases at a point-of-care facility, together with low cost portable imaging devices. In addition, the authors recommend a change in the way in which health care is delivered. This approach requires task-shifting within the healthcare provision system so that nurses, laboratory technicians, pharmacists and others are trained in the newly available technologies, thus enabling faster and more appropriate triage for people requiring medical treatment. This text: Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world Describes the major advances in healthcare outcomes in low-to middle-income countries derived from implementation of the United Nations/World Health Organisation’s 2000 Millennium Development Goals Provides a review of inexpensive rapid diagnostic point-of-care tests for infectious diseases in low-resource countries, particularly for people living in remote rural areas Provides a review of other rapid point-of-care services for assessing hematological function, biochemical function, renal function, hepatic function and status including hepatitis, acid-base balance, sickle cell disease, severe acute malnutrition and spirometry Explores the use of low-cost portable imaging devices for use in remote rural areas including a novel method of examining the optic fundus using a smartphone and the extensive value of portable ultrasound scanning when x-ray facilities are not available Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings Looks to the future of clinical management in remote impoverished rural settings using nucleic acid identification of pathogens, the use of nanoparticles for water purification, the use of drones, the use of pulse oximetry and the use of near-infrared spectroscopy Finally, it assesses the potential for future healthcare improvement in impoverished areas and how the United Nations/World Health Organization 2015 Sustainable Development Goals are approaching this. Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, Revolutionizing Tropical Medicine is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.




Sexually Transmitted Diseases


Book Description




Infectious Diseases and Nanomedicine II


Book Description

The book addresses the interdisciplinary scientific approach for the systemic understanding of connections between major human diseases and their treatment regime by applying the tools and techniques of nanotechnology. It also highlights the interdisciplinary collaborative researches for innovation in Biomedical Sciences. The book is a second volume which presents collection of best papers presented in the First International Conference on Infectious Diseases and Nanomedicine held during Dec. 15-18, 2012 in Kathmandu, Nepal. The book focuses mainly on the topics: emerging infectious diseases; antimicrobial agents, vaccines and immunity; drug design, drug delivery and tissue engineering and nanomaterials and biomedical materials.