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The diagnosis of fungal neglected tropical diseases (fungal NTDs) and the role of investigation and laboratory tests: An expert consensus report

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dc.creatorHay, Roderickspa
dc.creatorDenning, David Wspa
dc.creatorBonifaz, Alexandrospa
dc.creatorQueiroz-Telles, Flaviospa
dc.creatorBeer, Karlynspa
dc.creatorBustamante, Beatrizspa
dc.creatorChakrabarti, Arunalokespa
dc.creatorde Guadalupe Chavez-Lopez, Mariaspa
dc.creatorChiller, Tomspa
dc.creatorCornet, Murielspa
dc.creatorEstrada, Robertospa
dc.creatorEstrada-Chavez, Guadalupespa
dc.creatorFahal, Ahmedspa
dc.creatorGómez Giraldo, Beatríz Lucía
dc.creatorLi, Ruoyuspa
dc.creatorMahabeer, Yesholataspa
dc.creatorMosam, Anisaspa
dc.creatorRamarozatovo, Lala Soavinaspa
dc.creatorAndrianarivelo, Mala Rakotospa
dc.creatorRabenja, Fahafahantsoa Rapelanorospa
dc.creatorvan de Sande, Wendyspa
dc.creatorZijlstra, Eduard Espa
dc.date.accessioned2020-05-26T00:01:42Z
dc.date.available2020-05-26T00:01:42Z
dc.date.created2019spa
dc.description.abstractThe diagnosis of fungal Neglected Tropical Diseases (NTD) is primarily based on initial visual recognition of a suspected case followed by confirmatory laboratory testing, which is often limited to specialized facilities. Although molecular and serodiagnostic tools have advanced, a substantial gap remains between the desirable and the practical in endemic settings. To explore this issue further, we conducted a survey of subject matter experts on the optimal diagnostic methods sufficient to initiate treatment in well-equipped versus basic healthcare settings, as well as optimal sampling methods, for three fungal NTDs: mycetoma, chromoblastomycosis, and sporotrichosis. A survey of 23 centres found consensus on the key role of semi-invasive sampling methods such as biopsy diagnosis as compared with swabs or impression smears, and on the importance of histopathology, direct microscopy, and culture for mycetoma and chromoblastomycosis confirmation in well-equipped laboratories. In basic healthcare settings, direct microscopy combined with clinical signs were reported to be the most useful diagnostic indicators to prompt referral for treatment. The survey identified that the diagnosis of sporotrichosis is the most problematic with poor sensitivity across the most widely available laboratory tests except fungal culture, highlighting the need to improve mycological diagnostic capacity and to develop innovative diagnostic solutions. Fungal microscopy and culture are now recognized as WHO essential diagnostic tests and better training in their application will help improve the situation. For mycetoma and sporotrichosis, in particular, advances in identifying specific marker antigens or genomic sequences may pave the way for new laboratory-based or point-of-care tests, although this is a formidable task given the large number of different organisms that can cause fungal NTDs. © 2019 by the authors.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.3390/tropicalmed4040122
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/23397
dc.language.isoengspa
dc.publisherMDPI AGspa
dc.relation.citationIssueNo. 4
dc.relation.citationTitleTropical Medicine and Infectious Disease
dc.relation.citationVolumeVol. 4
dc.relation.ispartofTropical Medicine and Infectious Disease, Vol.4, No.4 (2019)spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85073010116&doi=10.3390%2ftropicalmed4040122&partnerID=40&md5=2fc4f786ab07dab130cf2a45e326c304spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordImpression materialspa
dc.subject.keywordArticlespa
dc.subject.keywordBiopsyspa
dc.subject.keywordChromomycosisspa
dc.subject.keywordConsensusspa
dc.subject.keywordFungus culturespa
dc.subject.keywordHealth care utilizationspa
dc.subject.keywordHistopathologyspa
dc.subject.keywordHumanspa
dc.subject.keywordLaboratory diagnosisspa
dc.subject.keywordLaboratory testspa
dc.subject.keywordMicroscopyspa
dc.subject.keywordMycetomaspa
dc.subject.keywordMycosisspa
dc.subject.keywordNeglected diseasespa
dc.subject.keywordNonhumanspa
dc.subject.keywordPatient referralspa
dc.subject.keywordPoint of care testingspa
dc.subject.keywordSporotrichosisspa
dc.subject.keywordTropical diseasespa
dc.subject.keywordChromoblastomycosisspa
dc.subject.keywordFungal ntdsspa
dc.subject.keywordIntegrated approachesspa
dc.subject.keywordLaboratory diagnosisspa
dc.subject.keywordMycetomaspa
dc.subject.keywordSporotrichosisspa
dc.titleThe diagnosis of fungal neglected tropical diseases (fungal NTDs) and the role of investigation and laboratory tests: An expert consensus reportspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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