Arbovirus and viral hemorragic fever unit, Institut Pasteur de Dakar, Dakar, Senegal.
Euro Surveill. 2015;20(44). doi: 10.2807/1560-7917.ES.2015.20.44.30053.
In the absence of a vaccine or specific treatments for Ebola virus disease (EVD), early identification of cases is crucial for the control of EVD epidemics. We evaluated a new extraction kit (SpeedXtract (SE), Qiagen) on sera and swabs in combination with an improved diagnostic reverse transcription recombinase polymerase amplification assay for the detection of Ebola virus (EBOV-RT-RPA). The performance of combined extraction and detection was best for swabs. Sensitivity and specificity of the combined SE and EBOV-RT-RPA were tested in a mobile laboratory consisting of a mobile glovebox and a Diagnostics-in-a-Suitcase powered by a battery and solar panel, deployed to Matoto Conakry, Guinea as part of the reinforced surveillance strategy in April 2015 to reach the goal of zero cases. The EBOV-RT-RPA was evaluated in comparison to two real-time PCR assays. Of 928 post-mortem swabs, 120 tested positive, and the combined SE and EBOV-RT-RPA yielded a sensitivity and specificity of 100% in reference to one real-time RT-PCR assay. Another widely used real-time RT-PCR was much less sensitive than expected. Results were provided very fast within 30 to 60 min, and the field deployment of the mobile laboratory helped improve burial management and community engagement.
在缺乏埃博拉病毒病（EVD）疫苗或特效治疗方法的情况下，早期发现病例对于控制 EVD 疫情至关重要。我们评估了一种新的提取试剂盒（SpeedXtract（SE），Qiagen）在血清和拭子上的应用，并结合改良的诊断逆转录重组酶聚合酶扩增检测法用于检测埃博拉病毒（EBOV-RT-RPA）。在一个由移动手套箱和由电池和太阳能板供电的“手提箱诊断仪”组成的移动实验室中，联合提取和检测的性能在拭子上最佳。联合 SE 和 EBOV-RT-RPA 的敏感性和特异性在 2015 年 4 月部署到几内亚科纳克里的马托托作为强化监测策略的一部分，以实现零病例目标时进行了测试。EBOV-RT-RPA 与两种实时 PCR 检测法进行了比较。在 928 例尸检拭子中，有 120 例检测为阳性，联合 SE 和 EBOV-RT-RPA 与一种实时 RT-PCR 检测法相比，敏感性和特异性均为 100%。另一种广泛使用的实时 RT-PCR 检测法的敏感性远低于预期。结果在 30 至 60 分钟内快速提供，移动实验室的现场部署有助于改善埋葬管理和社区参与。
