Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain ≥14 days): a multi-country, prospective, non-experimental case–control study

BMC Infectious Diseases

Study Protocol

Fransiska Meyanti¹  Elsa H. Murhandarwati¹  Jarir A. Thobari¹  Yodi Mahendradhata¹  Pascal Mertens²  Katja Polman³  Harry van Loen⁴  Emmanuel Bottieau⁴  Céline Schurmans⁴  Jan Jacobs⁴  Raffaella Ravinetto⁵  Jürg Utzinger⁶  Martin W. Bratschi⁶  Peiling Yap⁶  Pierre H. H. Schneeberger⁷  Sören L. Becker⁸  Jean T. Coulibaly⁹  Suman Rijal^1,10  Basudha Khanal^1,11  Narayan R. Bhattarai^1,11  Nisha K. Bhatta^1,12  Lisette van Lieshout^1,13  Marleen Boelaert^1,14  Kristien Verdonck^1,14  Ninon S. Horié^1,15  François Chappuis^1,15  Emilie Alirol^1,15  Cédric P. Yansouni^1,16  Mama N. Doumbia^1,17  Moussa Sacko^1,17  Mamadou S. Traoré^1,17  Aly Landouré^1,17  Rénion Saye^1,17  Lutz von Müller^1,18  Rosanna W. Peeling^1,19  Sakib Burza^1,19  Patrick K. Yao^2,20  Joel A. Yao^2,21  Kigbafori D. Silué^2,21  Eliézer K. N’Goran^2,21  Filip Meheus^2,22 

[1] Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia;Coris BioConcept, Gembloux, Belgium;Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;University of Basel, Basel, Switzerland;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;University of Basel, Basel, Switzerland;Department of Epidemiology and Molecular Diagnostics, Agroscope Changins-Wädenswil ACW, Wädenswil, Switzerland;Department of Virology, Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;University of Basel, Basel, Switzerland;Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;University of Basel, Basel, Switzerland;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;Department of Internal Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal;Department of Microbiology, B P Koirala Institute of Health Sciences, Dharan, Nepal;Department of Paediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal;Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland;Divisions of Infectious Diseases and Medical Microbiology, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada;Institut National de Recherche en Santé Publique, Bamako, Mali;Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany;London School of Hygiene and Tropical Medicine, London, United Kingdom;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;University of Cape Town, Cape Town, South Africa;

关键词: Bacteria;    Diagnosis-treatment algorithm;    Helminths;    Intestinal protozoa;    Neglected tropical diseases;    Persistent diarrhoea;    Côte d’Ivoire;    Indonesia;    Mali;    Nepal;   

DOI  :  10.1186/s12879-015-1074-x

 received in 2014-11-13, accepted in 2015-07-30,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundDiarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (<14 days), the spectrum of pathogens that may give rise to persistent diarrhoea (≥14 days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies.Methods/DesignThis multi-country, prospective, non-experimental case–control study will assess persistent diarrhoea (≥14 days; in individuals aged ≥1 year) and persistent abdominal pain (≥14 days; in children/adolescents aged 1–18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Côte d’Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies.DiscussionOur research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in the tropics. A diversity of intestinal pathogens will be assessed for potential associations with persistent diarrhoea and persistent abdominal pain. Different diagnostic methods will be compared, clinical symptoms investigated and diagnosis-treatment algorithms developed for validation in selected primary health care centres. The findings from this study will improve differential diagnosis and evidence-based clinical management of digestive syndromes in the tropics.Trial registrationClinicalTrials.gov; identifier: NCT02105714.

【 授权许可】

CC BY   
© Polman et al. 2015