Rapid Influenza Diagnostic Tests Improve Suitability of Antiviral Treatment in Hospitalized Children

2017 ◽  
pp. 1-6 ◽  
Author(s):  
Aneta Nitsch-Osuch ◽  
Ernest Kuchar ◽  
Izabela Gołębiak ◽  
Krzysztof Kanecki ◽  
Patryk Tarka ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Antiviral Treatment ◽  
Hospitalized Children

scholarly journals Increased Antiviral Treatment Among Hospitalized Children and Adults With Laboratory-Confirmed Influenza, 2010–2015

2016 ◽  
Vol 64 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Grace D Appiah ◽  
Sandra S Chaves ◽  
Pam D Kirley ◽  
Lisa Miller ◽  
James Meek ◽  
...  
Keyword(s):  
Influenza A ◽  
Antiviral Treatment ◽  
Population Based ◽  
Hospitalized Patients ◽  
Surveillance Data ◽  
Hospitalized Children ◽  
Influenza A H1n1

Abstract Using population-based surveillance data, we analyzed antiviral treatment among hospitalized patients with laboratory-confirmed influenza. Treatment increased after the influenza A(H1N1) 2009 pandemic from 72% in 2010–2011 to 89% in 2014–2015 (P < .001). Overall, treatment was higher in adults (86%) than in children (72%); only 56% of cases received antivirals on the day of admission.

scholarly journals Diagnostic performance evaluation of hepatitis B e antigen rapid diagnostic tests in Malawi

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexander J. Stockdale ◽  
Niza M. Silungwe ◽  
Isaac Thom Shawa ◽  
Benno Kreuels ◽  
Melita A. Gordon ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Diagnostic Tests ◽  
Antiviral Treatment ◽  
Rapid Diagnostic Tests ◽  
Hbv Dna ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hepatitis B E Antigen ◽  
Reference Test ◽  
Hospitalised Patients

Abstract Background The World Health Organization (WHO) has targeted a reduction in viral hepatitis-related mortality by 65% and incidence by 90% by 2030, necessitating enhanced hepatitis B treatment and prevention programmes in low- and middle-income countries. Hepatitis B e antigen (HBeAg) status is used in the assessment of eligibility for antiviral treatment and for prevention of mother-to-child transmission (PMTCT). Accordingly, the WHO has classified HBeAg rapid diagnostic tests (RDTs) as essential medical devices. Methods We assessed the performance characteristics of three commercially available HBeAg RDTs (SD Bioline, Alere, South Africa; Creative Diagnostics, USA; and Biopanda Reagents, UK) in two hepatitis B surface antigen-positive cohorts in Blantyre, Malawi: participants of a community study (n = 100) and hospitalised patients with cirrhosis or hepatocellular carcinoma (n = 94). Two investigators, blinded to the reference test result, independently assessed each assay. We used an enzyme-linked immunoassay (Monolisa HBeAg, Bio-Rad, France) as a reference test and quantified HBeAg concentration using dilutions of the WHO HBeAg standard. We related the findings to HBV DNA levels, and evaluated treatment eligibility using the TREAT-B score. Results Among 194 HBsAg positive patients, median age was 37 years, 42% were femaleand 26% were HIV co-infected. HBeAg prevalence was 47/194 (24%). The three RDTs showed diagnostic sensitivity of 28% (95% CI 16–43), 53% (38–68) and 72% (57–84) and specificity of 96–100% for detection of HBeAg. Overall inter-rater agreement κ statistic was high at 0.9–1.0. Sensitivity for identifying patients at the threshold where antiviral treatment is recommended for PMTCT, with HBV DNA > 200,000 IU/ml (39/194; 20%), was 22, 49 and 54% respectively. Using the RDTs in place of the reference HBeAg assay resulted in 3/43 (9%), 5/43 (12%) and 8/43 (19%) of patients meeting the TREAT-B treatment criteria being misclassified as ineligible for treatment. A relationship between HBeAg concentration and HBeAg detection by RDT was observed. A minimum HBeAg concentration of 2.2–3.1 log10IU/ml was required to yield a reactive RDT. Conclusions Commercially available HBeAg RDTs lack sufficient sensitivity to accurately classify hepatitis B patients in Malawi. This has implications for hepatitis B public health programs in sub-Saharan Africa. Alternative diagnostic assays are recommended.

scholarly journals Influenza Clinical Diagnostic Testing and Antiviral Treatment among Children Hospitalized with Acute Respiratory Illness During the 2015–16 Influenza Season

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S356-S356
Author(s):  
Angela P Campbell ◽  
Craig McGowan ◽  
Brian Rha ◽  
Julie A Boom ◽  
Janet Englund ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Influenza Season ◽  
Antiviral Treatment ◽  
Diagnostic Testing ◽  
Respiratory Illness ◽  
Molecular Testing ◽  
Hospitalized Children ◽  
Acute Respiratory Illness ◽  
Research Support ◽  
Clinical Diagnostic

Abstract Background Although antiviral therapy is recommended for hospitalized patients with suspected or confirmed influenza, clinicians often rely on test results to determine management. Rapid influenza diagnostic tests (RIDTs) have suboptimal sensitivity; use of molecular assays may improve care. We evaluated clinical influenza testing and antiviral treatment practices in hospitalized children. Methods Children aged <18 years with acute respiratory illness (ARI) were enrolled through active surveillance at 7 hospitals in the New Vaccine Surveillance Network between November 2015 and June 30, 2016; analysis was restricted to the influenza season. Preliminary data were analyzed for children who had clinical influenza diagnostic testing with a rapid influenza diagnostic test or molecular assay on nasopharyngeal or nasal swabs or nasal washes. Children who had received antivirals prior to hospitalization were excluded. Results Of 2267 children, 1165 (51%) had clinical diagnostic testing on upper respiratory samples: 276 (24%) by RIDT alone, 780 (67%) by molecular testing alone, and 109 (9%) by both. The use of molecular testing alone varied by site, from 10% to 100% of samples tested. Of 116 (10%) children testing positive for influenza, 60 (52%) were treated; by site, treatment of children positive for influenza ranged from 25% to 83%. Antiviral treatment was given to 16/20 (80%) of those admitted ≤2 days from symptom onset vs. 44/96 (46%) children admitted >2 days after onset. Among 94 children tested by one method who were positive, >80% had samples collected in the emergency department or on day of admission, and 47 started treatment (Figure, A): 16/37 (43%) and 31/57 (54%) were treated when tested by RIDT alone and molecular testing alone, respectively. Of those positive children treated, 7/16 (44%) tested by RIDT vs. 22/31 (71%) by molecular testing started treatment on the day of testing (Figure, B). Conclusion Half of hospitalized children with ARI who tested positive for influenza received antiviral treatment. Although there was high variability in testing and treatment by site, in positive patients who were treated the use of molecular testing appeared to be associated with prompt antiviral therapy. Understanding clinician reasons for relatively low treatment overall will require further investigation. Disclosures J. Englund, Gilead: Consultant and Investigator, Research support Chimerix: Investigator, Research support Alios: Investigator, Research support Novavax: Investigator, Research support MedImmune: Investigator, Research support GlaxoSmithKline: Investigator, Research support N. B. Halasa, sanofi pasteur: Research Contractor, Research support Astra Zeneca: Research Contractor, Grant recipient

scholarly journals Antiviral Treatment Among Hospitalized Children and Adults with Laboratory-Confirmed Influenza, 2010–2014 Seasons

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Grace D. Appiah ◽  
Sandra S. Chaves ◽  
Pam Daily Kirley ◽  
Lisa Miller ◽  
James I. Meek ◽  
...  
Keyword(s):  
Antiviral Treatment ◽  
Hospitalized Children

Images of Aging in the Psychotherapeutic Context

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 47-55 ◽  
Author(s):  
Eva-Marie Kessler ◽  
Catherine E. Bowen
Keyword(s):  
Old Age ◽  
Diagnostic Tests ◽  
Aging Process ◽  
Developmental Psychology ◽  
Mental Representations ◽  
Later Life ◽  
Future Research ◽  
Psychotherapeutic Process ◽  
Images Of Aging ◽  
Client Communication

Both psychotherapists and their clients have mental representations of old age and the aging process. In this conceptual review, we draw on available research from gerontology, social and developmental psychology, and communication science to consider how these “images of aging” may affect the psychotherapeutic process with older clients. On the basis of selected empirical findings we hypothesize that such images may affect the pathways to psychotherapy in later life, therapist-client communication, client performance on diagnostic tests as well as how therapists select and apply a therapeutic method. We posit that interventions to help both older clients and therapists to reflect on their own images of aging may increase the likelihood of successful treatment. We conclude by making suggestions for future research.

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