Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach
Abstract
:1. Introduction
2. Diagnostics
2.1. State-of-the-Art and Challenges in Human Diagnostics
2.2. State-of-the-Art and Challenges in Vector Diagnostics
2.3. Progress beyond the State-of-the-Art
- They offer the capability of multiplexing, thus increasing throughput without the need of costly and complex analysis methodologies, such as microarrays.
- They are diagnostically robust, they offer high sensitivity and specificity, they have been introduced in routine laboratory use for years, and are applicable to most laboratory settings.
- The exact same assays that are used in human diagnostics for pathogen detection can also be used in vector diagnostics (exact same species/serotypes/lineages of pathogens can be detected), thus making epidemiological information more universal.
- Both DNA and RNA determinations can be performed with exactly the same methodology from sample preparation to measurement.
- Especially TaqMan PCR allows (semi)quantitative information about the degree of infection in humans, enabling a correlation between the Ct value and the pathogen concentration (parasite/bacterium/virus).
- They can be integrated in an automated platform.
3. Packaging into Portable and Automated Platforms
3.1. Automation and Integration
- Provide the suitable interface for safe and contamination-free sample inlet. The sample inlet should be of universal nature in order to facilitate analysis from different matrices, such as whole blood, serum, sputum (in case of tuberculosis), or swab transport medium (in case of respiratory infections), but also mosquito homogenate samples.
- Automate sample preparation and interface it on the same cartridge with the NAAT mentioned in Section 2.
- Integrate and in situ store (bio)chemical reagents that are required for sample-to-answer analysis.
- Use a processing instrument, which incorporates the detection technology and reporting interface.
- Be adaptable in exchanging the desired targets according to endemic and epidemic needs, and geographical requirements.
3.2. State-of-the-Art in Automated Detection Technologies
3.2.1. VerePLEXTM Biosystem
3.2.2. Q-POCTM
3.2.3. LabDisk
4. Inclusion of Information and Communication Technologies
4.1. Clinical Algorithms for Patient Management
4.2. Surveillance and Data Management
4.2.1. Surveillance in Human Diagnostics
4.2.2. Data Management Systems in Entomology and Modern Communication Tools
4.2.3. An Integrated Data Management and Decision-Support System
4.3. Serious Games
5. Behavioral Change and Impact of a Holistic Approach
6. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Technology Platform | Amplification Technology | Portability a | Degree of Multiplexity b | Time-to-Result | Stand-Alone c | Application in Malaria |
---|---|---|---|---|---|---|
GeneXpert® (Omni) | RT-qPCR | Benchtop (modular); Omni: portable | Up to 6 | 60 min | No; Omni: Yes | No |
FilmArray® | Nested multiplex RT-qPCR; array-based detection | Benchtop | 27 | 60 min | No | No |
AlereTM i | NEAR d (isothermal) | Portable | 2 | 15 min | Yes | No |
Enigma® ML | RT-qPCR | Benchtop (modular) | 3 | 95 min | Yes | No |
cobas® Liat | RT-qPCR | Portable | 3 | 20 min | Yes | No |
EasyNATTM | CPA e (isothermal); visual readout in lateral flow strip | Handheld | 1 | 90 min | Yes | No |
Verigene® RP Flex System | RT-qPCR, gold nanoparticle detection | Benchtop (modular) | 16 | 2 h | Yes | No |
GenePOCTM | RT-qPCR | Benchtop | 12 | 60 min | Yes | No |
Liaison® MDX | RT-qPCR | Benchtop | 4 | 60 min | No | No |
VerePLEXTM Biosystem | PCR and microarray hybridization | Benchtop | 13 | ~3.5 h | No | In humans only |
Q-POCTM | qPCR | Handheld | 5 | 15 min | Yes | In humans only |
LabDisk (FeverDisk; demonstrator) | RT-LAMP | Portable | 12 | 2 h | No | In humans |
LabDisk (VectorDisk; under development) | RT-qPCR | Portable | 36 | Target: 2 h | No | In vectors |
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Mitsakakis, K.; Hin, S.; Müller, P.; Wipf, N.; Thomsen, E.; Coleman, M.; Zengerle, R.; Vontas, J.; Mavridis, K. Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach. Int. J. Environ. Res. Public Health 2018, 15, 259. https://doi.org/10.3390/ijerph15020259
Mitsakakis K, Hin S, Müller P, Wipf N, Thomsen E, Coleman M, Zengerle R, Vontas J, Mavridis K. Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach. International Journal of Environmental Research and Public Health. 2018; 15(2):259. https://doi.org/10.3390/ijerph15020259
Chicago/Turabian StyleMitsakakis, Konstantinos, Sebastian Hin, Pie Müller, Nadja Wipf, Edward Thomsen, Michael Coleman, Roland Zengerle, John Vontas, and Konstantinos Mavridis. 2018. "Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach" International Journal of Environmental Research and Public Health 15, no. 2: 259. https://doi.org/10.3390/ijerph15020259