Neonatal sepsis caused by Streptococcus agalactiae group B streptococcus (GBS) is a life-threatening condition, which is preventable if colonized mothers are identified and given antibiotic ...prophylaxis during labour. Conventional culture is time consuming and unreliable, and many available non-culture diagnostics are too complex to implement routinely at point of care. Loop-mediated isothermal amplification (LAMP) is a method that, enables the rapid and specific detection of target nucleic acid sequences in clinical materials without the requirement for extensive sample preparation.
A prototype LAMP assay targeting GBS sip gene is described.
The assay was 100 % specific for GBS, with a limit of detection of 14 genome copies per reaction. The clinical utility of the LAMP assay for rapid direct molecular detection of GBS was determined by testing a total of 157 vaginal swabs with minimal sample processing using a rapid lysis solution. Compared to a reference quantitative real-time PCR assay, the direct LAMP protocol had a sensitivity and specificity of 95.4 and 100 %, respectively, with positive and negative predictive values of 100 and 98.3 %, respectively. Positive and negative likelihood ratios were infinity and 0.05, respectively. The direct LAMP method required a mean time of 45 min from the receipt of a swab to generation of a confirmed result, compared to 2 h 30 min for the reference quantitative real-time PCR test.
The direct LAMP protocol described is easy to perform, facilitating rapid and accurate detection of GBS in vaginal swabs. This test has a potential for use at point of care.
The Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012. The objective of the study was to describe the epidemiology, risk factors, clinical characteristics, and outcome of ...MERS-CoV in Qatar. A total of 28 cases of MERS-CoV were identified, corresponding to an incidence of 1.7 per 1,000,000 population. Most patients had a history of contact with camels 15, travel to Kingdom of Saudi Arabia 7 or known contact with individuals with confirmed MERS-CoV infection 7. Majority of patients had acute kidney injury (AKI) 17 and 9 needed renal replacement therapy. All patients were hospitalized, 14 required critical care support. Overall, total of 10 died. The immediate cause of death was multiorgan failure with acute respiratory syndrome (ARDS) 9. MERS-CoV is a rare infection in the State of Qatar. There was no hospital outbreaks or healthcare worker reported infection. The infection causes severe respiratory failure and acute renal failure. Patients with AKI and on ventilator support carry higher risk of mortality.
One Health is increasingly recognized as an optimal approach to address the global risk of health threats originating at the human, animal, and ecosystem interface, and their impact. Qatar has ...successfully practiced One Health approach for investigation and surveillance of zoonotic diseases such as MERS-CoV, and other health threats. However, the current gaps at institution and policy level hinder the sustainment of One Health. In this paper, we have assessed the potential for implementation of One Health Framework to reinforce and sustain One Health capacities in Qatar for 2022–2027. To implement One Health Framework in the country, Qatar Joint External Evaluation (JEE) report, lessons learnt during One Health experiences on zoonotic, vector-borne, and food borne diseases were used to present an outline for multisectoral coordination. In addition, technical capacities of One Health and factors that are required to operationalize it in the country were also assessed in series of meetings and workshops held at Ministry of Public Health on March 2022. Present health care infrastructure and resources were found to be conducive for effective management and response to shared health threats as evident during MERS-CoV, despite being more event based. Regardless, the need for more sustainable capacity development was unanimously emphasized. The consensus between all relevant stakeholders and partners was that there is a need for better communication channels, policies and protocols for data sharing, and the need to invest more resources for better sustainability. The proposed framework is expected to strengthen and facilitate multilateral coordination, enhanced laboratory capacity and network, improve active surveillance and response, risk communication, community engagement, maximize applied research, and build One Health technical work force. This would enable advancement and sustainment of One Health activities to prevent and control health threats shared between humans-animals-ecosystem interface.
•MERS-CoV in Qatar constituted the catalyst for One Health Framework (OHF) development.•Technical capacities of One Health and factors that are required to operationalize this approach were evaluated.•Healthcare infrastructure and resources were found to be conducive for effective management and response to health threats.•Needs are emphasizing better communication channels, policies, and protocols for data sharing, and invest resources.•OHF proposes to strengthen multilateral coordination, improve active surveillance and response and build OH technical work force.
Background
External quality assessments (EQAs) for the molecular detection of human respiratory syncytial virus (RSV) are necessary to ensure the standardisation of reliable results. The Phase II, ...2019–2020 World Health Organization (WHO) RSV EQA included 28 laboratories in 26 countries. The EQA panel evaluated performance in the molecular detection and subtyping of RSV‐A and RSV‐B. This manuscript describes the preparation, distribution, and analysis of the 2019–2020 WHO RSV EQA.
Methods
Panel isolates underwent whole genome sequencing and in silico primer matching. The final panel included nine contemporary, one historical virus and two negative controls. The EQA panel was manufactured and distributed by the UK National External Quality Assessment Service (UK NEQAS). National laboratories used WHO reference assays developed by the United States Centers for Disease Control and Prevention, an RSV subtyping assay developed by the Victorian Infectious Diseases Reference Laboratory (Australia), or other in‐house or commercial assays already in use at their laboratories.
Results
An in silico analysis of isolates showed a good match to assay primer/probes. The panel was distributed to 28 laboratories. Isolates were correctly identified in 98% of samples for detection and 99.6% for subtyping.
Conclusions
The WHO RSV EQA 2019–2020 showed that laboratories performed at high standards. Updating the composition of RSV molecular EQAs with contemporary strains to ensure representation of circulating strains, and ensuring primer matching with EQA panel viruses, is advantageous in assessing diagnostic competencies of laboratories. Ongoing EQAs are recommended because of continued evolution of mismatches between current circulating strains and existing primer sets.
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