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Introduction <p>Due to the difficulty in attributing a causative agent to acute febrile illnesses (AFI), multi-pathogen diagnostic tools should be prioritized in low-resource settings. A previously developed AFI-TaqMan Array Card (AFI-TAC), capable of detecting 26 pathogens within 2&#xa0;h of nucleic acid extraction, was evaluated in Uganda.</p> Methods <p>A cross-sectional retrospective study design was employed and utilized 182 viral hemorrhagic fever (VHF)-negative samples collected from Uganda, DRC, South Sudan and Kenya during routine surveillance from August 2018- March, 2019. These samples were tested on AFI-TAC targeting 17 viral, 8 bacterial and 3 protozoal pathogens known to cause fever. Patients with a body temperature of ≥ 38&#xa0;°C, were bleeding, and had any other febrile symptoms were included. Previously confirmed VHF positive samples were used for assay verification.</p> Results <p>Overall, 7 pathogens were detected in 59 samples (32.42%) as follows: <i>Plasmodium</i> spp. (<i>n</i> = 49, 26.92%), non-typhoidal Salmonella (<i>n</i> = 3, 1.65%), Yellow Fever (YF) virus (<i>n</i> = 2, 1.10%), <i>Salmonella enterica</i> serovar <i>typhi</i> (<i>n</i> = 2, 1.10%), <i>Leptospira</i> spp (<i>n</i> = 1, 0.55%), <i>Streptococcus pneumoniae</i> (<i>n</i> = 1, 0.55%) and <i>Rickettsia</i> spp. (<i>n</i> = 1, 0.55%). Final outcome (alive vs. dead) as abstracted from case report forms differed significantly by pathogen category (<i>p</i> = 0.002) was significantly associated with assay positivity. We compared outcome across pathogen categories using a chi-square/Fisher’s exact test, as appropriate, reporting p-values (Table&#xa0;2). Cough was the only clinical symptom significantly associated with <i>Plasmodium</i> infection (<i>p</i> = 0.016).</p> Conclusion <p>The TAC is a feasible, readily adoptable diagnostic tool for use in Uganda and other sub-Saharan countries, particularly when incorporated into the national testing algorithm for differential diagnosis during AFI outbreaks and surveillance.</p> Clinical trial number <p>Not applicable.</p>

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Utility of TaqMan Array Cards for detection of acute febrile illness etiologies in patients suspected of viral hemorrhagic fever infections

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Gloria Grace Akurut,
  • Luke Nyakarahuka,
  • Shannon Whitmer,
  • Dianah Namanya,
  • Kilama Kamugisha,
  • Sophia Mulei,
  • Jimmy Baluku,
  • Alex Tumusime,
  • Jackson Kyondo,
  • Ketan Patel,
  • Julius J. Lutwama,
  • Trevor Shoemaker,
  • Joel Montgomery,
  • John D. Klena,
  • Stephen Balinandi

摘要

Introduction

Due to the difficulty in attributing a causative agent to acute febrile illnesses (AFI), multi-pathogen diagnostic tools should be prioritized in low-resource settings. A previously developed AFI-TaqMan Array Card (AFI-TAC), capable of detecting 26 pathogens within 2 h of nucleic acid extraction, was evaluated in Uganda.

Methods

A cross-sectional retrospective study design was employed and utilized 182 viral hemorrhagic fever (VHF)-negative samples collected from Uganda, DRC, South Sudan and Kenya during routine surveillance from August 2018- March, 2019. These samples were tested on AFI-TAC targeting 17 viral, 8 bacterial and 3 protozoal pathogens known to cause fever. Patients with a body temperature of ≥ 38 °C, were bleeding, and had any other febrile symptoms were included. Previously confirmed VHF positive samples were used for assay verification.

Results

Overall, 7 pathogens were detected in 59 samples (32.42%) as follows: Plasmodium spp. (n = 49, 26.92%), non-typhoidal Salmonella (n = 3, 1.65%), Yellow Fever (YF) virus (n = 2, 1.10%), Salmonella enterica serovar typhi (n = 2, 1.10%), Leptospira spp (n = 1, 0.55%), Streptococcus pneumoniae (n = 1, 0.55%) and Rickettsia spp. (n = 1, 0.55%). Final outcome (alive vs. dead) as abstracted from case report forms differed significantly by pathogen category (p = 0.002) was significantly associated with assay positivity. We compared outcome across pathogen categories using a chi-square/Fisher’s exact test, as appropriate, reporting p-values (Table 2). Cough was the only clinical symptom significantly associated with Plasmodium infection (p = 0.016).

Conclusion

The TAC is a feasible, readily adoptable diagnostic tool for use in Uganda and other sub-Saharan countries, particularly when incorporated into the national testing algorithm for differential diagnosis during AFI outbreaks and surveillance.

Clinical trial number

Not applicable.