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Análise comparativa da PCR em tempo real, nested PCR e teste imunocromatográfico em amostras de sangue processadas em pool, como plataforma de diagnóstico molecular e sorológico de malária em larga escala; Comparative analysis of real-time PCR, nested PCR and immunochromatographic test in blood samples processed in pool, as a platform for molecular and serological diagnosis of malaria on large-scale

Lima, Giselle Fernandes Maciel de Castro
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/05/2011 PT
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35.91%
O diagnóstico da malária tem como teste de referência a gota espessa, porém é consenso que é preciso adotar alternativas em situações específicas, com técnicas mais sensíveis e que possam ser aplicadas no processamento de grande número de amostras, como estudos clínicos, epidemiológicos ou triagem de doadores em bancos de sangue. Com a finalidade de formar uma plataforma de diagnóstico para malária em amostras agrupadas em pools, foi realizada análise comparativa da PCR em tempo real, a nested PCR e um teste rápido específico para detecção de anticorpos contra P.falciparum e P. vivax, com intuito de reduzir o número de ensaios, com custo relativamente baixo. Foram utilizadas 50 amostras de sangue positivas para Plasmodium, de acordo com a prevalência das espécies no Brasil (P. vivax 75%, P. falciparum 22% e P. malariae 3%), com diagnóstico realizado pelo método padrão ouro. Adicionalmente, 48 amostras de sangue negativas para Plasmodium foram selecionadas para controle negativo e confecção de 15 pools, contendo amostras positivas e negativas. Quatro das amostras negativas para malária eram positivas para outras doenças. Tanto as amostras positivas como as negativas foram submetidas individualmente aos ensaios de PCR em tempo real...

Avaliação de dose nos sistemas de irradiação de bolsas de sangue para esterilização; Evaluation of radiation dose in systems of blood bag for sterilization

Oliveira, Paulo Marcio de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 23/07/2014 PT
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35.96%
O procedimento de esterilização do sangue é adotado para que sejam mínimas as condições necessárias de manifestação da doença do enxertoversus- hospedeiro associada à transfusão de sangue (DECHT), síndrome, geralmente fatal. Neste trabalho foi utilizada a solução Fricke gel desenvolvida no IPEN para a obtenção de um objeto simulador de bolsa de sangue empregada no processo de irradiação para esterilização de sangue em um irradiador Gammacell Elan. O objetivo desse trabalho é determinar a homogeneidade da dose aplicada no processo de esterilização de bolsas de sangue. Foram utilizadas as técnicas de Espectrofotometria de Absorção Óptica (EAO), Densitometria Óptica (DO), Termoluminescência (TL) e Ressonância Magnética por Imagem (RMI) e os softwares Numaris® versão 4 (Syngo-MR-A30) e MatLab® (versão 9.0) para a aquisição e reconstrução das imagens. O estudo foi realizado posicionando no canister do irradiador inicialmente uma bolsa e, posteriormente, duas bolsas e três bolsas e aplicando uma dose nominal de 25 Gy. O fabricante do irradiador Gammacell Elan recomenda que seja irradiado em cada procedimento o valor máximo de três bolsas de sangue. Os resultados obtidos indicam que o irradiador Gammacell Elan não demostrou homogeneidade na distribuição da dose. Irradiando uma bolsa de sangue foi obtida uma diferença de dose de 3...

Field evaluation of the whole blood immunochromatographic test for rapid bancroftian filariasis diagnosis in the northeast of Brazil

Braga,Cynthia; Dourado,Maria Inês; Ximenes,Ricardo Arraes de A.; Alves,Luiz; Brayner,Fabio; Rocha,Abraham; Alexander,Neal
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2003 EN
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35.87%
This study evaluated the whole blood immunochromatographic card test (ICT card test) in a survey performed in Northeastern Brazil. 625 people were examined by the thick blood film (TBF) and ICT card test. Residents of a non-endemic area were also tested by the whole blood card test and Og4C3. The sensitivity of the ICT card test was 94.7% overall, but lower in females than males, based on the reasonable assumption that TBF is 100% specific. However, since TBF and other methods have unknown sensitivity, the true specificity of the card test is unknown. Nevertheless, it is possible to estimate upper and lower limits for the specificity, and relate it to the prevalence of the disease. In the endemic area, the possible range of the specificity was from 72.4% to 100%. 29.6% of the card tests performed in the non-endemic area exhibited faint lines that were interpreted as positives. Characteristics of the method including high sensitivity, promptness and simplicity justify its use for screening of filariasis. However, detailed information about the correct interpretation in case of extremely faint lines is essential. Further studies designed to consider problems arising from imperfect standards are necessary, as is a sounder diagnostic definition for the card test.

Diagnosis of Plasmodium falciparum Malaria at Delivery: Comparison of Blood Film Preparation Methods and of Blood Films with Histology

Rogerson, Stephen J.; Mkundika, Patrick; Kanjala, Maxwell K.
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
Publicado em /04/2003 EN
Relevância na Pesquisa
46.16%
We compared peripheral and placental blood films (made by different techniques) with placental histology for diagnosis of Plasmodium falciparum malaria in pregnancy. Samples from 464 women were examined, of whom 124 (26.7%) had active P. falciparum infection and 148 (31.9%) had past infection. Placental histology was more sensitive (91%) than peripheral blood film (47%) or placental blood film (63%) examination and also detected past infection. Few women had microscopically detectable infection without a positive histology. Infection detected by histology only and past infection were both associated with significantly lower infant birth weight and with lower hemoglobin concentrations compared to the results for uninfected women. Thick blood films were prepared with blood obtained by placental incision or scraping of the incision margin (263 samples) or by washing of placental tissue (235 samples). Each gave similar sensitivities (76 to 78%), specificities (98 to 99%), positive predictive values (92 to 98%), and negative predictive values (93 to 94%); but the median levels of parasitemia were lower for incision samples (840 parasites/μl) than scrapings (2,295 parasites/μl) (P = 0.02). Placental histology is the most sensitive method for the diagnosis of malaria in pregnancy. Methods for preparation of placental films may affect the density...

Red blood cell abnormalities in cardiac valvular disease

Forshaw, J.; Harwood, L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1967 EN
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Nineteen patients with morphological abnormalities of the red blood cells are described, and these formed approximately 3% of the total cases of cardiac valvular disease. In two patients the abnormal blood film developed after the insertion of an aortic and mitral valve prosthesis respectively, but in another two patients the abnormal blood film was corrected by aortic valve surgery. Anisopoikilocytosis may have been associated with microangiopathic haemolytic anaemia in one patient, but in the others the cardiac valvular disease was severe and other mechanical factors were not present. The mitral valve was involved in 16 patients and the aortic valve in eight.

Blood film examination for vacuolated lymphocytes in the diagnosis of metabolic disorders; retrospective experience of more than 2500 cases from a single centre

Anderson, G; Smith, V V; Malone, M; Sebire, N J
Fonte: Copyright 2005 Journal of Clinical Pathology Publicador: Copyright 2005 Journal of Clinical Pathology
Tipo: Artigo de Revista Científica
Publicado em /12/2005 EN
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45.94%
Background: A range of metabolic diseases can result in abnormal accumulation of metabolic byproducts, resulting in abnormal lymphocyte cytoplasmic vacuolation, identifiable on routine blood film examination.

Blood, Sweat and Cheers: Absurdist Crime Films and Contemporary Society

Meisner, Christopher
Fonte: Brock University Publicador: Brock University
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Within the crime film tradition there is a plethora of sub-genres all of which relate to crime and its consequences. However, directors Joel and Ethan Coen, Quentin Tarantino and David Lynch, all of whom create plots around crime and criminality, have been difficult to pin down and attribute to any given sub-genre. This thesis demonstrates that an absurdist philosophy can be used to effectively examine the content of the previously mentioned filmmakers. Through an analysis of these filmmakers and their better known works compelling evidence is revealed suggesting that these filmmakers may all belong to the emerging crime film sub-genre known as absurdist crime films.

Silent film music composition in a cross-cultural context.

Guo, Xiaoduo
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2012
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36.11%
This submission realizes the project Silent Film Music Composition in a Cross-Cultural Context through the composition of music for an excerpt from the silent film “Peach Blossom Weeps Tears of Blood” (Shanghai, 1931). The portfolio consists of a DVD of a 58-minute segment of the film with the newly composed soundtrack. Accompanying it is an exegesis addressing the research questions for this project and outlining the process of composition. The combination of Chinese and Western musical materials in the soundtrack was a major focus of the composition. The music is also designed to explain the rich historical background of the film and is intended to help contemporary audiences, who come from different cultures and age groups, to understand the emotions that are depicted on-screen. The entire score was created on the computer using Logic 9 software. All the instruments used are from the sound library of Logic and the final soundtrack in DVD format has been mastered using Logic. The accompanying exegesis explains the aims of this research and the questions that are to be answered. Research began with investigation into early film music, paying particular attention to Chinese silent films. Several significant reasons are listed for the choice of a Chinese silent film. In order to give a general idea of the development of the Chinese film industry...

Une méthode dangereuse : comprendre le processus créateur en musique de film, le cas de Norman McLaren et Maurice Blackburn, David Cronenberg et Howard Shore

Hellégouarch, Solenn
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
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Si Norman McLaren (1914-1987) œuvre principalement dans le domaine onirique de l’animation, David Cronenberg (1943-), parfois surnommé « The Baron of Blood », réalise des films de fiction appartenant à un genre singulier qu’il a lui-même développé, celui de « l’horreur intérieure ». Que peuvent donc partager ces deux cinéastes aux univers a priori si distincts ? Chacun a construit une relation à long terme avec un compositeur : Maurice Blackburn (1914-1988) pour le premier, Howard Shore (1946-) pour le second. Mais si les univers des deux réalisateurs ont été maintes fois investigués, l’apport de leurs compositeurs respectifs demeure peu examiné. Or, d’un univers à l’autre, la musique semble jouer un rôle de toute première importance, chacun des compositeurs étant impliqué très tôt dans le processus cinématographique. Cette implication précoce dans la création collective est indicatrice de la place et du rôle centraux qu’occupent Blackburn et Shore et leur musique au sein de l’œuvre de McLaren, d’une part, et de Cronenberg, de l’autre. De la sorte, les partitions semblent ne pouvoir être considérées comme une simple illustration sonore des films, mais comme une composante tout à fait fondamentale...

ETIOLOGY OF YELLOW FEVER : VII. DEMONSTRATION OF LEPTOSPIRA ICTEROIDES IN THE BLOOD, TISSUES, AND URINE OF YELLOW FEVER PATIENTS AND OF ANIMALS EXPERIMENTALLY INFECTED WITH THE ORGANISM.

Noguchi, Hideyo
Fonte: The Rockefeller University Press Publicador: The Rockefeller University Press
Tipo: Artigo de Revista Científica
Publicado em 01/08/1919 EN
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Examinations of fresh blood from yellow fever patients by means of the dark-field microscope, made in more than twenty-seven cases, revealed in three cases the presence of Leptospira icteroides. In no instance was a large number of organisms found, a long search being required before one was encountered. The injection of the blood into guinea pigs from two of the three positive cases induced in the animals a fatal infection, while the blood from the third positive case failed to infect the guinea pigs fatally. Careful but by no means exhaustive dark-field searches for the leptospira with fresh specimens of blood from the remaining cases of yellow fever ended without positive findings, although four of the specimens, when injected into guinea pigs, caused a fatal leptospira infection. Stained blood film preparations from the corresponding cases were also examined, but the percentage showing the leptospira in the blood was no greater than that found by examination in the fresh state with the dark-field microscope. In fact, owing to the defective stains that were available at the time of the investigation a great many slides did not take the proper coloration with Giemsa's or Wright's stain and could not be relied upon. Regarding the presence of Leptospira icteroides in various organs both dark-field and stained films were examined. In only one instance so far a few organisms were detected in the emulsion of liver taken shortly after death from a case dying on the 4th day of yellow fever. This part of the work will be reported later upon completion. Examinations of the urine from different cases of yellow fever were made both by dark-field microscope and by inoculation into guinea pigs. The results were totally negative in thirteen cases...

PERIPHERAL BLOOD FILM - A REVIEW

Adewoyin, AS; Nwogoh, B.
Fonte: Association of Resident Doctors (ARD), University College Hospital, Ibadan Publicador: Association of Resident Doctors (ARD), University College Hospital, Ibadan
Tipo: Artigo de Revista Científica
Publicado em /12/2014 EN
Relevância na Pesquisa
46%
The peripheral blood film (PBF) is a laboratory work-up that involves cytology of peripheral blood cells smeared on a slide. As basic as it is, PBF is invaluable in the characterization of various clinical diseases. This article highlights the basic science and art behind the PBF. It expounds its laboratory applications, clinical indications and interpretations in the light of various clinical diseases. Despite advances in haematology automation and application of molecular techniques, the PBF has remained a very important diagnostic test to the haematologist. A good quality smear, thorough examination and proper interpretation in line with patient's clinical state should be ensured by the haemato-pathologist. Clinicians should be abreast with its clinical utility and proper application of the reports in the management of patients.

THE DIAGNOSTIC VALUE OF THE PLACENTAL BLOOD FILM IN ÆSTIVO-AUTUMNAL MALARIA

Clark, H. C.
Fonte: The Rockefeller University Press Publicador: The Rockefeller University Press
Tipo: Artigo de Revista Científica
Publicado em 01/10/1915 EN
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46.29%
1. The placental blood film examination is worthy of routine application wherever æstivo-autumnal malaria is endemic. This type of malaria when associated with labor and the early days of the puerperium can be more easily and certainly diagnosed by the use of this film and a polychrome stain than by employing the usual films made from the mother's peripheral blood at the time of labor. The placental film in such an infection offers an abundance of adult parasites and far more evidence of the presence of pigment, while the peripheral blood film frequently offers but a scant number of the small ring or discoid forms of a parasite. The examination of the present series revealed positive placental films in nineteen cases, while but eight of these same cases were positive in the peripheral blood film examination. On the other hand, no peripheral blood films were found positive in which the associated placental films did not reveal a far more abundant evidence of the infection. 2. The early days of the puerperium can by this method be protected many times from a malarial outburst, and, as a rule, puerperal sepsis can be differentiated. 3. The intricate vascular architecture of the mature placenta rivals that of the spleen, liver, and bone marrow as a harbor for adult malarial parasites of this type and as a storage for pigment. 4. The localization of parasites in the placenta is unique. Here is the one vascular system which particularly favors the development of the parasites but which at the same time is so situated that it may be spontaneously discarded by the body at the climax of the attack. By this simple act late in pregnancy the prognosis for both mother and child may be improved. 5. The pregnant state encourages attacks of malaria by lowering bodily resistance and by furnishing an additional harbor for the development of parasites. A tenable theory in regard to most attacks of this nature...

Assessing the Performance of CareStart Malaria Pf/Pv Combo Test Against Thick Blood Film in the Diagnosis of Malaria in Northwest Ethiopia

Hailu, Tadesse; Kebede, Tadesse
Fonte: The American Society of Tropical Medicine and Hygiene Publicador: The American Society of Tropical Medicine and Hygiene
Tipo: Artigo de Revista Científica
Publicado em 04/06/2014 EN
Relevância na Pesquisa
35.9%
Bivalent rapid diagnostic tests are promising diagnostic tools for Plasmodium falciparum and P. vivax. Their diagnostic performance was evaluated against thick blood smear to assist national malaria control programs. A cross-sectional study was conducted to evaluate the performance of CareStart against thick blood smears among 398 acute febrile patients visiting the Felegeselam Health Center in December of 2011. Thick blood smears were examined under 100× objectives to diagnose Plasmodium species. Similarly, CareStart Malaria Pf/Pv Combo Test was performed as per the manufacturer's instruction. The ability of CareStart Malaria Pf/Pv Combo Test to diagnose Plasmodium malaria was very good, with 99.8% (95% confidence interval = 97.7–100%) sensitivity and 97.7% (95% confidence interval = 94.6–99.1%) specificity. The sensitivity and specificity of the CareStart Test is comparable with the thick blood smear in diagnosing malaria. Hence, it is preferable to use the CareStart Malaria Pf/Pv Combo Test instead of microscopy in areas where microscopic diagnosis is limited.

Etudes sur l'hémolymphe de l'abeille - 1ère partie: les frottis de sang de l'abeille adulte d'été; Studies on the bee hemolymph - Part 1 : Blood film on summer adult honeybee

Wille, H.; Vecchi, M. A.
Fonte: INRA - Instituto Nacional de Investigação Agronômica da França Publicador: INRA - Instituto Nacional de Investigação Agronômica da França
Tipo: Journal Article-postprint
FR
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45.94%
On a étudié dans le présent travail les composants cellulaires du sang de l'abeille adulte d'été. Les résultats ont été obtenus avec la méthode des frottis et se rapportent à l'hémolymphe prélevée dans la tète, le thorax et l'abdomen d'abeilles de races et d'âges différents. Les divers éléments cellulaires du sang sont décrits, la nomenclature adoptée est comparée à celle des autres auteurs. Comme éléments nouveaux les prochromatinocytes et les chromatinocytes sont présentés. Ils jouent un rôle important lors de la multiplication des hémocytes (fig. 1). Le rassemblement temporaire de certains éléments cellulaires en des "concentrations d'hémocytes" est apparemment en étroite relation avec des réactions du métabolisme. Suivant l'âge de l'abeille la proportion des différents types de cellules montre une certaine variabilité. Par exemple entre le 6e et le 1Oe jour le nombre de cellules libres diminue nettement, tandis que celui de "concentrations d'hémocytes" est en augmentation (tableaux 2, 3, 4). Les variations dans la fréquence des différents éléments du sang et les nombreuses formes de transition toujours présentes suggèrent divers cycles évolutifs des hémocytes (fig. 5). Le problème des possibilités de renouvellement des hémocytes est discuté. La multiplication de ces cellules par voie amitotique est rare...

North American desire for the Spanish Other : Three film versions of Blasco Ibáñez's Blood and Sand

Cumberland, Sharon
Fonte: Universidade Autônoma de Barcelona Publicador: Universidade Autônoma de Barcelona
Tipo: Article; info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em //1999 ENG
Relevância na Pesquisa
36.16%
There are three film versions of Vicente Blasco Ibáñez's taurine novel Sangre y arena (1908). All are entitled Blood and Sand and feature male and female actors who epitomise the erotic possibilities of the North American fascination with Spanish stereotypes: Rudolph Valentino in 1922, Tyrone Power and Rita Hayworth in 1941, and Sharon Stone in 1989. By comparing the three film versions of Blood and Sand to Sangre y arena, it becomes clear that the North American appropriation of Spanish stereotypes displaces Blasco Ibáñez's theme of class conflict onto a safely diffused locus of erotic desire. Included are discussions of stereotypes in North American literary and film culture, Hollywood and North American audiences, and the españolada tradition compared to other North American genres.

Sangre fresca publicitaria : True Blood y las transfusiones de la ficción

Rodríguez Ferrándiz, Raúl
Fonte: Universidade Autônoma de Barcelona Publicador: Universidade Autônoma de Barcelona
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em //2012 SPA
Relevância na Pesquisa
35.9%
El artículo analiza el concepto de transmedia storytelling en su dimensión publicitaria. En cierto modo, las narrativas transmediáticas, esto es, la diseminación de las tramas ficcionales a lo largo de soportes y plataformas diversos pero sinérgicos (letra impresa, cine, televisión), fueron empleadas en primer lugar en el mensaje publicitario, obligado a transmigrar por su carencia de un soporte exclusivo y a cambio por la vocación de colonizarlos a todos. Hoy día es el producto cultural ficcional el que devuelve a la publicidad el préstamo: son los universos ficcionales los marcos más propiciatorios para el consumo, no solo de la cultura industrial en sí, en cualquiera de sus soportes, sino de todo un rosario de marcas arracimadas en torno a la narrativa ficcional. Analizaremos en detalle este fenómeno en una teleserie norteamericana muy reciente, True Blood (HBO, 2008), todavía en emisión, y en todo el universo ficcional que orbita a su alrededor. La diferencia entre los productos culturales en sí y las piezas publicitarias encargadas de promocionarlos –como ya vio premonitoriamente Adorno– se disuelve en un continuo crosspromotional, que tiende a enmascarar también los límites entre las estrategias corporativas y las intervenciones del fan.; This article discusses the concept of transmedia storytelling in its advertising dimension. In a way...

A Photomicrographic Method for the Detection of Oxygen Content in the Hemoglobin of the Red Blood Cell

Levine, Bruce Martin; Sager, Craig
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
36.11%
Previous attempts at photographing the hemoglobin in the red blood cells have been confined to the making of two separate images of the same blood sample; one image is recorded using a wavelength band in the isobestic point region of the spectral distribution of oxygenated and reduced blood, and the other image is made using a wavelength band of radiation in the area of greatest difference in absorption between the two blood states. The method described here attempts to obtain a measurement of oxygenation by means of only one exposure using both regions of wavelengths simultaneously. The response is the density on film of the images of the two blood samples as recorded on color reversal film. A dilute blood sample was deoxygenated with nitrogen gas using a closed chamber. The blood solution was then transfered to a closed 100 micrometer depth chamber through which photomicrographs were made. Fully oxygenated blood was photographed In the same manner. Microdensitometric traces of the Images of individual oxygenated and reduced blood cells show that the meen density of the images of oxygenated hemoglobin in the cells was signifigantly greater than that of the reduced red blood cells.

Avaliação do teste imunocromatográfico ("ICT card test") no diagnóstico da filariose em estudos populacionais; Field evaluation of the whole blood immunochromatographic test for rapid bancroftian filariasis diagnosis in the northeast of Brazil

Braga, Cynthia; Dourado, Maria Inês; Ximenes, Ricardo Arraes de A.; Alves, Luiz; Brayner, Fabio; Rocha, Abraham; Alexander, Neal
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/06/2003 ENG
Relevância na Pesquisa
35.87%
Este estudo avaliou o teste imunocromatográfico ("ICT card test") em inquérito de filariose realizado no município de Olinda, Brasil. 625 pessoas foram examinadas pela técnica da gota espessa (GE), e "ICT card test" (ICT). Moradores do município de Campina Grande, Paraíba, área não endêmica, foram examinados pelos testes ICT e Og4C3-ELISA, para verificação da especificidade. A sensibilidade do método foi de 94,7%. O desenho do estudo - que envolveu a acurácia do ICT e do teste de referência (GE), em todos os elementos da amostra, - e a especificidade de 100% da GE permitiram o cálculo correto da sensibilidade. Todavia, como a sensibilidade da GE é desconhecida, a especificidade do ICT é ignorada. É possível, contudo, estimar o limite superior e inferior da especificidade e relacioná-la à prevalência de doença. Na área endêmica, a especificidade do teste variou entre 72,4% e 100,0%. 29,6% dos exames pelo ICT, realizados na área não endêmica, exibiram coloração tênue, tendo sido interpretados como positivos. Algumas características do método, incluindo alta sensibilidade, rapidez e simplicidade de execução justificam sua utilização em rastreamento de áreas endêmicas. Todavia, detalhes acerca da correta interpretação dos resultados com coloração extremamente tênue...

Solubility tests and the peripheral blood film method for screening for sickle-cell disease: a cost benefit analysis

Okwi,Andrew Livex; Ocaido,Michael; Byarugaba,Wilson; Ndugwa,Christopher Magala; Parkes,Arthur
Fonte: SAMJ: South African Medical Journal Publicador: SAMJ: South African Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2009 EN
Relevância na Pesquisa
46.08%
OBJECTIVE: To determine the cost benefit of screening for sickle-cell disease among infants at district health centres in Uganda using sickling, solubility tests and the peripheral blood film method. METHODS: Pilot screening services were established at district health centres. Cost benefit analysis (CBA) was performed in four scenarios: A1 - where there are no sickle-cell screening services at district health centres and all children are referred either to Mulago national referral hospital or A2 - a regional hospital for haemoglobin (Hb) electrophoresis; B1 - when there are screening services at district health centres, only positive samples are taken either to Mulago Hospital or B2 - the regional hospital for confirmation using haemoglobin electrophoresis. Calculations were done in Uganda shillings (USh). RESULTS: Initial operational costs were high for all scenarios but variably reduced in the subsequent years. Scenarios A1 and A2 were very sensitive compared with B1 and B2. Scenario A1 had the highest screening costs in the subsequent years, costing over 62 000 USh per test in both eastern and western Uganda. Scenario B2 was sensitive and cheaper when using the sickling test, but was expensive and insensitive when using the solubility test and more insensitive though cheaper when using the peripheral blood film method. CONCLUSION AND RECOMMENDATION: Screening children in Mulago hospital using haemoglobin electrophoresis (A1) was very expensive although it was sensitive. Screening the children at four health centres using the sickling method and confirming positive samples at a regional hospital (B2) was both cheap and sensitive and is therefore recommended.

External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

Mukadi,Pierre; Gillet,Philippe; Lukuka,Albert; Atua,Benjamin; Sheshe,Nicole; Kanza,Albert; Mayunda,Jean Bosco; Mongita,Briston; Senga,Raphaël; Ngoyi,John; Muyembe,Jean-Jacques; Jacobs,Jan; Lejon,Veerle
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
Relevância na Pesquisa
46.08%
OBJECTIVE: To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. METHODS: A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113 530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. FINDINGS: Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%...