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Context: Typhoid fever is a major health problem in developing countries and its diagnosis on clinical ground is difficult. Diagnosis in developing countries including Madhya Pradesh is mostly done by Widal test. However, the value of the test has been debated. Hence, evaluating the result of this test is necessary for correct interpretation of the result. Aims: A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients. Settings and Design: Materials and Methods: Blood samples were collected from 62 febrile patients with symptoms clinically similar to typhoid fever and visiting red cross Hospitals at bhopal from mid May 2018 to August 2018. Blood culture was used to isolate S.typhi and S.paratyphi. Slide agglutination test and tube agglutination tests were used for the determination of antibody titer. Statistical analysis used: Data analysis by IBM SPSS Statistics 20 Results: 10 participants were females and 22 were males in blood culture and 20 were positive, 12 were negative. Total 62 cases of S. typhi were identified with the total prevalence of typhoid fever. The total number of patients who have indicative of recent infection by either of O and H antigens. Conclusions: Total 62 cases of S. Typhi or paratyphi were identify with the total prevalence of typhoid fever.Widal test is 30 patients were observed and blood culture were observed 32 patients. Keywords: Widal test, Blood culture, Sensitivity, Positive predictive value, Negative predictive value.

Background: Blood group plays a unique role in revealing the identity of an individual. Several studies have expressed variations in bleeding tendencies among individuals with various ABO blood groups. Hence a study was done to the find association of bleeding and clotting time with this blood group. Materials and Methods: This study had a cross-sectional study design and was done among 250 young adults. Slide agglutination method was used to assess ABO blood group; while Dukes and capillary tube method were used to determine bleeding and clotting time respectively. Chi-square analysis was done to analyze its association with blood group. Results: Blood group O (38.4%) was found to be the major blood group among both genders, followed by B (34%), A (19.2%), AB (0.08%). Bleeding time of more than 4 minutes was found in both O and B group but the result was statistically not significant (p=0.85). Clotting time of more than 6 minutes was found again in both O and B groups and the difference was not significant (p=0.96). Bleeding time was found to be higher in males while Clotting time was found to be more prolonged in females however the difference was statistically less significant (p>0.05). Conclusion: In this study, results have shown that blood group O was the predominant blood group among the study population and blood group O and B had prolonged bleeding and clotting time compared to other groups. Based on gender, females had higher clotting time compared to males. Keywords: ABO antigen, Agglutination, von Willebrand factor.

Background: Typhoid fever is a serious public health problem. It causes severe systemic infection in lesser developed areas of the world. Although blood culture is regarded as the gold standard for diagnosis, it is a time taking procedure. An early and accurate diagnosis is necessary for an effective treatment. Aims: The present study was done to comparatively evaluate rapid card and Widal slide agglutination tests for rapid diagnosis of typhoid cases. Settings and Design: The study design was a cross-sectional descriptive study done over a period of 6 months from January to June 2018. Materials and Methods: A total of 265 patients suspected of typhoid fever who gave their consent were included in the study whose blood samples were tested by both rapid card and Widal slide agglutination tests. Statistical Analysis Used: The collected data were analyzed using SPSS Data Editor Software version 20. Percentage of variables was calculated. Results: Of 265 patients, 97 patients were positive by the Widal slide test, whereas 113 patients were positive by the rapid card test, with 96.9% sensitivity and 88.7% specificity. Of 113 positives, 83 cases were positive for immunoglobulin M (IgM) only, whereas 30 cases were positive for both IgM and IgG. Conclusion: Rapid card test is a simple and easy to perform the diagnostic test for rapid detection of typhoid cases with an additional advantage of separate determination of IgM and IgG antibody, thereby aiding in identification of current infection and previous exposure so that appropriate and timely treatment could be given to the patients.

Background and Objectives:The objective of this study was to evaluate the frequency of the ABO blood groups in sample of patients diagnosed with Diabetes Mellitus in Gujarat population.Methods:Case - control study. The study has been carried out in Patients reporting to Medicine department and donor of blood bank of Dhiraj General Hospital, SVU, Pipariya, Vadodara, Gujarat. The study included total 400 patients above 18 years of age were selected, out of which 200 were normal healthy controls (nondiabetic) and 200 patients with diabetes. Blood samples were collected from the Patients after consent had been obtained, thus giving the response rate of 82.4 %. The ABO blood groups of all subjects were determined and recorded by Slide Agglutination method at Haematology laboratory and Blood bank.Results:Data were analysed by “one sample chi square test”. The x² test results showed that there was association between the frequency of ABO blood group and Diabetes Mellitus. The data revealed that the blood group B was significantly more common in diabetic patients as compared with Non-diabetic healthy population (25.5% vs. 23.5%; P < 0.001). Blood group O was significantly less common in diabetic patients compared with non-diabetics (38.5% vs. 44.5%; P < 0.001). Among diabetic men, the frequency of only blood group B was significantly higher, while on the contrary among diabetic women the frequency of both A and B (29.8% vs. 25%; P = 0.033 and 25.7% vs. 19.7%; P < 0.0087, respectively) were significantly higher as compared with nondiabetic healthy population.Conclusion:Our study confirms that the frequency and association exist between the blood group and type of Diabetes Mellitus in this Gujarat population. The findings in this study suggest that ABO antigens are associated with DM. DM is more common in individuals with blood group B. Therefore, a larger extensive study is needed to establish the correlation.

Typhoid fever remains a public health challenge in developing countries including Nigeria. Widal test is widely used for the diagnosis of typhoid fever due to its simplicity and short turnaround time. However, the specificity of this test has been debated. The aim of the study was to evaluate the performance of Widal test compared to blood culture and determine interferon gamma response among the study subjects. Blood samples were collected from 90 patients who complained of fever and other symptoms suggestive of typhoid fever. Widal slide agglutination test, automated blood culture and interferon gamma concentrations were conducted using rapid antibody detection kit, BACTEC and sandwich enzyme linked immunosorbent assay (ELISA) respectively. Of the 90 samples tested, 63 (70.0%) were positive for anti-Typhi O antigen while 42 (46.7%) were positive for anti-Typhi H antigen. Similarly, 18 (20%) of the blood samples were non- S. Typhi culture positive while 72 (80%) had no bacteria isolated. None of the cases had S. Typhi positive culture. With regards to interferon gamma, subjects with lower levels of 15pg/mL had no bacteria isolated from their blood. As the interferon gamma concentration increased, more subjects had non- S. Typhi bacteria isolated from their blood which shows the relationship between interferon gamma and bacteraemia. The study demonstrated that the use of Widal serology test in the diagnosis of typhoid fever may be erroneous as all the samples were found to be negative for S. Typhi using the gold standard culture methods while Interferon gamma concentration was statistically related to the isolation of non- S. Typhi in blood culture as such, could be a good marker for the development of an alternative screening test, possibly an interferon gamma based detection system for typhoid fever. However, further research is recommended to elucidate that. Keywords: Typhoid, Widal test, Blood culture, Interferon gamma

Aims This study developed and evaluated a loop-mediated isothermal amplification (LAMP) assay to simply, rapidly and accurately identify Shigella flexneri serotypes 2 and Xv. Methods and Results The LAMP assay based on the O-antigen synthesis and modification genes of S. flexneri including gtrII, gtrX, opt and wzx was developed. Its specificity and sensitivity were evaluated with 19 serotypes of S. flexneri and 96 other Shigella species and bacterial pathogens commonly found in stool samples. This LAMP assay was completed within 20 min at 61°C and could detect boiled DNA samples at concentrations as low as 1 pg/μl. The S. flexneri serotype LAMP assay exhibited 100% specificity for detecting 19 S. flexneri serotypes, no 96 strains of Shigella spp. and other bacterial pathogens. This LAMP assay was used to identify S. flexneri serotypes 2 and Xv from 299 S. flexneri strains isolated in China and results were consistent with that of slide agglutination and multiplex polymerase chain reaction results for the same isolates. Conclusions This LAMP assay may facilitate rapid and reliable identifying S. flexneri serotypes 2 and Xv. Significance and Impact of Study The present study was the first LAMP method for identifying serotypes of S. flexneri.

Objective of the work was to conduct an extended study of Legionella strains isolated from epidemiologically significant environmental objects during the preparation and conduct of mass events in the territory of the Russian Federation in 2013-2014 . Materials and methods . Studied were 53 strains of Legionella pneumophila, isolated from epidemiologically significant objects during the preparation and conduct of a number of mass events (ME): XXVII World Summer Universiade, XXII Olympic Winter Games and XI Paralympic Winter Games, Sochi; Summer Health Promotion Campaign in 2014, Republic of Crimea; IV Caspian Summit, Astrakhan, 2014. Strains were analyzed using multilocus sequencing, time-of-flight mass spectrometry (MALDI-ToF-MS) and atomic force microscopy. Legionella strains were typed by multilocus sequencing in accordance with the algorithm of the European Legionellosis Research Group “Sequence-Based Typing protocol for epidemiological typing of L. pneumophila ". Results and discussion . Strains of L. pneumophila , legionellosis agent, were isolated in the territory of the Republic of Crimea, Moscow, Kazan, Sochi, Astrakhan and characterized. According to the results of slide agglutination, 17 L. pneumophila strains were assigned to 1 serogroup , 37 - to 2-14 serogroups. Based on the data obtained by multilocus sequencing, in accordance with the algorithm of the European Working Group on Legionellosis Surveillance, allelic profiles of all the studied L. pneumophila strains were identified; their belonging to 7 sequence types was established. Using the method of time-of-flight mass spectrometry, legionella strains were characterized, their protein profiles were studied, and a database was formed. Using the method of scanning probe microscopy, information was obtained on the morphology of the cells of 18 legionella strains and the features of their surface structures. Using the methods of multilocus sequencing, time-of-flight mass spectrometry, and atomic force microscopy, molecular-genetic, proteomic, and morphometric features of Legionellosis pathogen strains that circulate in epidemiologically significant sites in the Russian Federation were determined.

Introduction: Studies regarding pulmonary tuberculosis (PT) and blood group correlations were reported from different parts of globe. But there was huge disparity. Hence a study was conducted to find the relation between PT and ABO Rh blood group. Materials and Methods: Individuals with signs and symptoms suggestive of PT were included in the study. Two spot sputum samples were collected, sputum smears were stained by ZN staining. Simultaneously, ABO blood grouping and Rh typing was done for all the participants by slide agglutination test. P value of

Salmonella is a common pathogenic bacterium. Salmonella isolates have been sorted into different serogroups according to the specific lipopolysaccharide present in the somatic surface (O antigen) of the bacterium. The virulence and pathogenicity of Salmonella vary greatly between different serogroups. Salmonella of O:2, O:3, O:4, O:7, and O:9 serogroups contribute to a large share of Salmonella outbreaks. Traditional slide agglutination tests to classify Salmonella serogroups are tedious because of their low testing efficiency, complex operation, and subjective judging criteria. Immunochromatographic assays have been extensively described in the literature, which discussed their low cost, rapid detection, and portability in multitude of fields, such as agriculture and environmental sciences. In this study, a biosensing multiplexer based on immunochromatographic assay (bio-MUX) was designed for rapid and high-throughput classification of five Salmonella serogroups. The five tests for the serogroups (i.e., O:2, O:3, O:4, O:7, and O:9) were integrated in three test lines. The results can be exported rapidly in 15 min. The sensitivity and specificity for the five serogroups exceeded 96% and 97%, respectively. No expensive or large instruments were needed in the bio-MUX. With these advantages, the proposed bio-MUX deserves to be promoted and expanded for on-site circumstances and specialized laboratories.

Background. The diagnosis of typhoid fever based on the Widal slide agglutination test remains a major hurdle in developing countries due to varied perceptions of the value of the Widal test in determining clinical decision-making. We undertook a study to evaluate the diagnostic performance of the Widal test and the Typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods. Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer’s guidelines. A composite reference of fever plus positive coproculture for Salmonella typhi and Salmonella paratyphi was used as the reference. The sensitivity, specificity, and predictive values of the positive and negative tests were calculated as well as Cohen’s kappa for agreement between the two tests. Results. Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test, while 15.59% were positive for Typhidot-IgM. The overall sensitivity, specificity, and predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6%, and 97.03% for Typhidot-IgM and 94.44%, 48.35%, 21.32%, and 98.33% for the Widal slide agglutination test, respectively. Cohen’s kappa estimates were 0.1660 (0.121–0.211) and 0.386 (0.312–0.460) for the Widal test and Typhidot immunoassay for 53.6% and 76.16% agreements of all observations, respectively. Conclusion. The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of typhoid fever in our setting.

Staphylococcus aureus interacts with fibrinogen in plasma to form macroscopic clumps of cells. A simple and rapid slide agglutination test using rabbit plasma has been employed in clinical labs to distinguish S. aureus from most coagulase negative Staphylococci. The method described here is a quantitative clumping assay in which S. aureus cells are mixed with either plasma or purified fibrinogen, and clumps are allowed to sediment out of solution. Clearing of the overlying solution is monitored over time by measuring the optical density at 600 nm and comparing these values to the initial turbidity. This simple assay can be used to study regulation and expression of various cell wall-anchored adhesins.

Background: The diagnosis of Typhoid fever, based on the Widal slide agglutination test, remains a major hurdle in developing countries like Cameroon due to varied perceptions of the value of the Widal test in determining clinical decision making. We undertook a study to evaluate the diagnostic performance of the Widal test and the typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods: Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum from whole blood was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer’s guidelines. A composite reference of fever plus positive coproculture for Salmonella enteric serovars typhi and paratyphi was used as reference. The sensitivity, specificity, predictive values of the positive and negative tests were calculated as well as the Cohen’s Kappa for agreement between the two tests. Results: Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test while 15.59% were positive for typhidot-IgM. The overall sensitivity, specificity, predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6% and 97.03% respectively for typhidot-IgM; 94.44%, 48.35%, 21.32% and 98.33% for Widal slide agglutination test. The Cohen’s kappa estimates were 0.1660 (0.121-0.211), 0.386 (0.312-0.460) for Widal test and typhidot immunoassay respectively, with agreements of 53.76% and 76.16% respectively. Conclusion: The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of Typhoid fever in our setting.

Aim: To assess the efficacy and reliability of saliva in identification of ABO blood grouping. Materials and Method: The study was conducted in the outpatient department of Oral Medicine and Radiology. The serum and saliva of 50 participants were collected and the blood group of the individual from serum was identified by the slide agglutination method and from saliva by the absoption elution method. Results: Data obtained were subjected to statistical analysis using Paerson’s chi square test and it showed high significance (P =

Bacterial black node, a disease of barley and wheat, is caused by Pseudomonas syringae pv. syringae (synonym pv. japonica, hereafter Psj). Here a selective medium, serine-potassium tellurite-based Psj-selective agar (SPTPsjA) was developed to isolate and detect Psj. After 5–7 days on SPTPsjA at 25 °C, characteristic black Psj colonies formed with an efficiency equal to that on potato–peptone–glucose agar. Except for P. viridiflava, P. cichorii, and some strains of P. syringae group bacteria, SPTPsjA either inhibited growth of other phytopathogenic bacteria or enabled their discrimination. To facilitate diagnosis of Psj, we prepared three antisera against three strains; in a slide agglutination test, the antisera reacted to all tested strains of Psj and failed to react to P. viridiflava and P. cichorii although some strains of other P. syringae group bacteria were indistinguishable from Psj with SPTPsjA and antisera. When barley and wheat seeds from fields in which bacterial black node had occurred were placed on SPTPsjA in the dark at 25 °C for 7 days, black colonies grew on the medium around the seeds. Among these strains, only those responsive to the above antisera were pathogenic on barley. These results show that the combination of SPTPsjA and antisera can isolate Psj from seeds of barley and wheat.

Aim and Objective: To study the changing profile of enteric fever with reference to clinical features and complications and also study the response of enteric fever to various drugs. Methodology: The present study was carried out of 75 cases of enteric fever and admitted to the paediatric department of Dr VRK Womens hospital and Princess Durru Shehvar Hospital from March 2018 to September 2018, Cases diagnosed as enteric fever. In all cases, a detailed Clinical history, complete physical examination, family history, history of Contact with patient of enteric fever, the type of water supply, post immunisation Status of enteric fever were asked. Only those cases with a rising litre by slide agglutination or Positive tube agglutination more than 1:80 or Positive blood culture reports were included in this study to know the clinical profile. Children between the ages of 0-12 years were selected for the study. Results: 75 cases of enteric fever in children up to 12 years of age formed the study group. 67% were boys and 33% were girls. The youngest patient in our study was 9 months old. Fever was seen in all cases. The fever was high grade, continuous in 60% and intermittent in 40% cases. General malaise and weakness were seen in all cases. Tongue coating was noticed in all cases. Splenomegaly was seen in 82.4% cases and hepatomegaly was seen in 58.4% cases. The widal agglutination by slide method showed rising titers in 49 cases. The tube agglutination was positive in 26 cases. Cases which showed positive results with both slide agglutination test and tube agglutination were 10. Blood culture was positive in 5 cases. The initial treatment started was amoxycillin in 27 cases. Amoxycillin was changed to cipro floxacillin in 11 cases and it was changed to ceftriaxone in 6 cases and amoxycillin was changed to chloramphenicol in 2 cases. Conclusion: Finally concluded that, this study on enteric fever shows the changing trends in the clinical features and management. Ceftriaxone and Cipro floxacillin were found to be very effective.

Introduction: Enteric fever is the major health problem of developing country like India, with a notable morbidity and mortality. Isolation of Salmonella the causative agent from Blood is the standard laboratory method for diagnosis, but it is not available at PHC level. So, rapid and affordable diagnostic test like Widal tube and slide agglutination test are used. The present study was done to comparatively evaluate the Widal slide agglutination and tube agglutination test in detecting enteric fever. Methods: A total of 500 patients with clinical presentation suggestive of enteric fever were included in the study whose venous blood was collected. All the samples were tested for the presence of anti O and anti H agglutinins against S. typhi and S. paratyphi A by semi quantitative slide and quantitative tube agglutination tests as per standard protocols. The titers of 1:80 (O agglutinins) and 1:160 (H agglutinins) were taken as the significant titer for the diagnosis of enteric fever. Results: Out of 500 collected samples, 183 (36.6%) was positive by slide agglutination test, whereas, only 145 (29%) were positive by tube agglutination method. The slide test had a sensitivity of 97.2%, specificity of 88.1%, positive predictive value of 77% and negative predictive value of 98.7% as compared to Widal tube agglutination test. Conclusions: Due to high false positivity shown by slide test, it is suggested that serological diagnosis should not be made solely on the basis of slide test rather its results should be confirmed by using Widal tube agglutination test. Keywords: Enteric fever, Slide agglutination test, Widal tube agglutination test, Sensitivity, Specificity

Neisseria meningitidis is an etiological factor of invasive meningococcal disease (IMD). This Gram-negative diplococcus is transmitted from person to person via droplets or through a direct physical contact with secretions of infected patients or asymptomatic carriers. The latter account for 5-10% of the general population. The aim of the study was to estimate the actual N. meningitidis carriage rate in the military environment with identification of serogroups, genogroups, sequence types and clonal complexes of the isolates detected among Polish soldiers. The study was conducted during winter seasons of 2015 and 2016 and involved 883 professional soldiers from the Armoured Brigade in Świetoszow, Poland. The material for testing were nasopharyngeal swabs obtained from study participants. The samples were tested using standard microbiological methods (culture, incubation, microscopy, biochemical and automated identification). N. meningitidis isolates were subjected to slide agglutination test (identification of serogroups), the bacterial DNA was extracted and allowed to determine genogroups, clonal complexes and sequence types. 76 soldiers were found to be carriers of N. meningitidis , they accounted for 8.6% of the study group. The meningococcal isolates mostly belonged to serogroup B. Sequence types ST-11439, ST-136, ST-1136 and the clonal complex 41/44CC were found to be predominant. Clonal complexes responsible for IMD were detected in 15.8% of carriers and 1.4% of the whole study participants. Carriage rates of N. meningitidis among Polish soldiers were found to be similar to those reported in the general population. Neisseria meningitidis is an etiological factor of invasive meningococcal disease (IMD). This Gram-negative diplococcus is transmitted from person to person via droplets or through a direct physical contact with secretions of infected patients or asymptomatic carriers. The latter account for 5–10% of the general population. The aim of the study was to estimate the actual N. meningitidis carriage rate in the military environment with identification of serogroups, genogroups, sequence types and clonal complexes of the isolates detected among Polish soldiers. The study was conducted during winter seasons of 2015 and 2016 and involved 883 professional soldiers from the Armoured Brigade in Świetoszow, Poland. The material for testing were nasopharyngeal swabs obtained from study participants. The samples were tested using standard microbiological methods (culture, incubation, microscopy, biochemical and automated identification). N. meningitidis isolates were subjected to slide agglutination test (identification of serogroups), the bacterial DNA was extracted and allowed to determine genogroups, clonal complexes and sequence types. 76 soldiers were found to be carriers of N. meningitidis, they accounted for 8.6% of the study group. The meningococcal isolates mostly belonged to serogroup B. Sequence types ST-11439, ST-136, ST-1136 and the clonal complex 41/44CC were found to be predominant. Clonal complexes responsible for IMD were detected in 15.8% of carriers and 1.4% of the whole study participants. Carriage rates of N. meningitidis among Polish soldiers were found to be similar to those reported in the general population.

Objective: The study was conducted to determine the presence of methicillin resistant Staphylococcus aureus (MRSA) in chickens and farm personnel in Sokoto, North-western Nigeria. Materials and method: A total of 160 samples (136 from chickens and 14 from personnel) were collected and screened for the presence of MRSA using cultural characteristics, biochemical tests and latex slide agglutination test for the presence of Penicillin binding protein 2α (PBP2α). Results: MRSA were detected in 8.82% (n=12/136) of chickens, while 14.29% (n=2/14) in farm personnel. All the isolates were positive for PBP2α. Conclusion: This study established for the first time the occurrence of MRSA in both chickens and farm personnel from poultry farms in Sokoto, Nigeria. Thus, the study provided baseline information for further studies on the epidemiology of MRSA. [J Adv Vet Anim Res 2017; 4(3.000): 255-260]

Introduction: Data collection on the Salmonella occurrence is crucial in effective implementation of different actions or control programmes aiming to protect consumers’ health and to reduce the level of Salmonella prevalence in farm animals. The goal was to describe Salmonella serovar distribution along the food chain in Poland during 2010–2015 and to identify their epidemiological importance. Material and Methods: Slide agglutination according to White-Kauffmann-Le Minor scheme was used to identify Salmonella serovars of 6,928 isolates originating from animals, food, feeds, and fertilisers. Results: In total, 160 Salmonella serovars were identified. Differences in serovar distribution were observed depending on animal species. Among isolates from hens, S. Enteritidis and S. Infantis were the most prevalent. Serovar pattern in turkeys differed from those in hens, with S. Kentucky, S. Newport, S. Saintpaul being the most prevalent. Monophasic S. Typhimurium was predominant in pigs. Serovars found in food reflected those observed among livestock animals. Nine out of the ten most prevalent serovars in animals and humans were also found in organic fertilisers. Conclusion: Serotyping of large number of isolates from different sources is essential for insight on emerging serovars and trends of Salmonella occurrence. This may increase the value of epidemiological data and result in updating of Salmonella control programmes to target further epidemiologically important serovars in animals and better protection of consumers’ health.

Introduction Invasive meningococcal disease (IMD) has a high rate of fatality and may cause severe clinical sequelae. Over the years, the epidemiology of IMD has changed significantly in various regions of the world, and laboratory surveillance of this disease is important for mapping epidemiologic changes. Aim To perform phenotypic characterization of Neisseria meningitidis strains isolated from invasive disease in Brazil from 2002 to 2017, as a complementation of the data obtained in the period of 1990-2001. Methodology In total, 8,689 isolates sent to Adolfo Lutz Institute confirmed as N. meningitidis by conventional methods were serogrouped by slide agglutination against MenA, MenB, MenC, MenE, MenW, MenX, MenY and MenZ; serotyped and serosubtyped by a whole-cell dot-blotting assay with monoclonal antibodies. Results The isolates were sent from all regions of Brazil, and the southeast region was responsible for the largest number of isolates (57.2 %). Overall, the total sample (n=8,689) was represented by serogroups C (n=4,729; 54.4 %), B (n=3,313; 38.1 %), W (n=423; 4.9 %), Y (n=203; 2.3 %), X (n=5; 0.1 %) and others (n=16; 0.2 %). A shift in the prevalence of serogroups was observed in 2006, when serogroup C became the most prevalent (65.5 %), surpassing the serogroup B (21.9 %). The main isolated phenotypes were C:23:P1.14-6; B:4,7:P1.19,15; W:2a:P1.5 and W:2a:P1.5,2. Conclusion The data show an important change in the distribution of meningococcal serogroups, serotypes and subtypes occurring during 2002-2017. A continuous laboratory-based surveillance provides robust information to implement appropriate strategies to IMD control.

OBJECTIVE To determine the distribution pattern of ABO and Rhesus blood groups among different ethnic populations in an urban centre. METHODS The retrospective cross-sectional study was conducted at Kharadar General Hospital, Karachi, from May to Dec 2017, and comprised antenatal and walk-in individuals of different ethnic groups who were tested at the hospital's clinical laboratory. Blood groups typing was carried out using Slide Agglutination (antigen-antibody) method with antisera anti-A, anti-B, and anti-D. SPSS 16 was used for data analysis. RESULTS Of the 3521 subjects, 1253(35.6%) had blood group O, 1167(33.1%) group B, 849(24.1%) group A and 252(7.2%) had group AB. Also, 3209(91.1%) were Rhesus-positive and 312(8.9%) Rhesus-negative. Blood group Opositive was predominant in Balochi 381(41%), Mohajir 197(36%), Sindhi 147(38%), Hindko 39(44%) and Seraiki14(43.8%) groups, while B-positive was common among Pathan 207(35%), Punjabi 116(35%), Kacchi 123(37%), Memon 79(37%) and Bengali 20(36%) groups. CONCLUSIONS O positive was the most common and AB negative was the least common blood groups among different ethnic populations of Karachi.

Objectives To: (1) assess the frequency of crossmatch incompatibility in naive feline blood transfusion recipients using two crossmatching methods, (2) measure the effect of crossmatch incompatibility on change in packed cell volume following transfusion, (3) assess the frequency of acute transfusion reactions and errors in blood transfusions in cats and (4) assess the impact of crossmatch incompatibility on the likelihood of transfusion reactions. Materials and Methods Cats being administered a first AB‐matched transfusion in a veterinary teaching hospital were prospectively recruited for this observational study. A slide agglutination method and a commercial test were both used for major and minor crossmatching. We measured increase in packed cell volume at 12 hours after transfusion relative to the mass of red blood cells given per recipient bodyweight and recorded transfusion reactions. Results A total of 101 cats was included. Crossmatch incompatibility was common using the slide agglutination method (27% and 10% major and minor incompatibility, respectively), but less common with the commercial test (major and minor incompatibility both 4%). Crossmatch incompatibility with any method was not associated with less effective transfusion in terms of change in packed cell volume. Transfusion reactions occurred in 20 cats, most commonly febrile non‐haemolytic transfusion reactions (n = 9) and haemolytic transfusion reactions (n = 7). The commercial test appeared to be most specific for predicting haemolytic transfusion reactions. Clinical Significance Transfusion reactions were fairly common but not associated with increased mortality. Use of crossmatch‐compatible blood did not lead to a greater increase in PCV at 12 hours. The commercial test may predict a haemolytic transfusion reaction.

Salmonella Pullorum is a pathogen that infects several species of birds, mainly offspring, and among them, quails. Therefore, this study was performed in order to evaluate the S. Pullorum shedding in experimentally infected Japanese quails (Coturnix coturnix) and egg contamination ability. S. Pullorum ATCC lyophilized was inoculated in all birds (60 quails at 160 days). Before the inoculation, rapid slide agglutination test was performed in all birds and individual cloacal swabs were collected randomly. Birds from group A and group B received 0.5mL of inoculum containing 1.5x102 CFU and 7.5 x 108 CFU of S. Pullorum, respectively, directly in the crop. The cloacal swab samples were collected on 3, 6, 9, 16 and 23 days post-inoculation (dpi) and all eggs were collected. Positive cloacal swab samples were initiated at the 3rd dpi. A total of 30 pool of eggs was analyzed, of which 73% positive for S. Pullorum until the 16th dpi. In conclusion, adult Japanese quails are possibly more resistant to the infection by S. Pullorum, but they can shed this pathogen in the environment as well.

Limited data is accessible about the seroprevalence of Toxoplasma gondii infection in backyard (free-range) chickens in Ethiopia. This cross-sectional study was carried out from November 2018 to April 2019 to estimate the seroprevalence and assess associated risk factors of T. gondii infection in backyard chickens in Northwest Ethiopia. Serum samples were collected from 384 backyard chickens. Toxoplasma gondii antibodies were assayed using Toxo-Latex slide agglutination test. Seropositivity for T. gondii antibodies was confirmed in 72.4% of 384 birds. Altitude, presence of cat and dog around the house, age, breed and water source were considered as potential risk factors (p .05) associated with Toxoplasma seropositivity in this study. But, sex was not identified as a predictor for Toxoplasma infection even though higher seroprevalence was observed in females (73.7%) than males (69.3%). In conclusion, this study indicates a high prevalence of T. gondii infection in backyard chickens in Northwest Ethiopia. Therefore, further works on epidemiology, bioassay, isolation and genetic characterization of the pathogen are imperative. It also warrants an action to prevent and control T. gondii infection in backyard chickens that could serve as an important intermediate host and pose a potential threat for consumers.

Objective: To determine the carriage and the serogroup distribution of Neisseria meningitidis in military academy applicants in the Russian Federation. Design: This was a prospective, observational study of adults aged >18 years from a military academy; applicants who had samples taken on arrival (Day 1), and applicants who had samples taken after passing exams (Day 30) and 60 days after arrival. N. meningitidis serogrouping was determined by slide agglutination tests of isolates and real-time PCR. Results: Samples were provided by 671 applicants on Day 1 and 261 applicants on Day 30, with 232 of these also providing samples on Day 60. N. meningitidis was detected in 16.2% of samples from Day 1, 7.7% of samples from Day 30 and 15.9% of samples from Day 60. Serogroup composition was most diverse at Day 1, with serogroups B and W dominant (40% [17/43 isolates] and 9% [4/43], respectively; 30% [13/43] ungroupable); by Day 60, there was a low diversity, with 58% (14/24 isolates) serogroup W. Conclusions: While carriage of N. meningitidis in this study appeared stable, there was an increase in carriers of serogroup W in this population. Given recent increases in outbreaks attributed to serogroup W, further monitoring may be considered. Keywords: Neisseria meningitidis, Russian Federation, Carriage, Serogroup W

Background: Enteric fever is a major public health problem with significant morbidity and mortality in developing countries. Although, isolation of causative organism from blood is the standard laboratory method, but due to frequent use of self-medication by patients, and its long turnaround time, it is seldom used, and enteric fever is usually diagnosed by using serological methods. Widal tube agglutination test is the standard serological test used, which is now a days replaced by slide agglutination test due to its convenience and rapidity. The present study was done to comparatively evaluate the slide agglutination and Widal tube agglutination test in detecting enteric fever. Methods: A hospital based cross-sectional study was done from January to June 2016. A total of 117 patients with clinical presentation suggestive of enteric fever were included in the study whose venous blood was collected and serum was tested by both slide agglutination and Widal tube agglutination test. Results: Out of 117 patients, slide agglutination test showed positive results in 39 (33.3%) samples, whereas, Widal tube agglutination test showed positive results in 23 (19.7%) samples only. The slide test had a sensitivity of 91.3%, specificity of 80.9%, positive predictive value of 53.8% and negative predictive value of 97.4% as compared to Widal tube agglutination test. Conclusions: Due to high false positivity shown by slide test, it is suggested that serological diagnosis should not be made solely on the basis of slide test rather its results should be confirmed by using Widal tube agglutination test.

Objective To determine the prevalence of the different capsular polysaccharide (CP) and major surface-associated non-CP antigen 336 (SP-336) types among Staphylococcus aureus isolated from bovine mastitis cases in Australia and India. Methods A total of 414 strains (154 from Australia, 260 from India) isolated from clinical bovine mastitis were included in the study. Mouse antisera raised against CP types (CP1, CP2, CP5, and CP8) or SP-336 were used in slide agglutination tests and compared with detection of cap1, cap5 and cap8 gene fragments by PCR. Results Serological studies revealed the presence of CP2, CP5, CP8 and SP-336 in 9.1%, 23.4%, 31.8%, and 5.8% of the Australian versus 0.8%, 46.9%, 13.1% and 0% of the Indian isolates, respectively. By PCR, CP1, CP5 and CP8 accounted for 0%, 26.6% and 32.4% of the Australian versus 3.9%, 85% and 8.1% of the Indian isolates, respectively. Conclusions Both PCR and the serological method demonstrated that CP5 and CP8 are the predominant capsular types in Australia, whereas CP5 is the predominant capsular type in India. The study also demonstrated a strong correlation between both methods of typing for CP1, CP5, CP8 and non-typeable S. aureus strains. High-percentage prevalence of non-typeable isolates in both the countries highlights the importance of continued investigations of the identification of unique surface-associated polysaccharide antigens prevalent among S. aureus isolates for the formulation of CP- and SP-based vaccines for bovine mastitis.

Aim: The aim of the study is to find out the role of common haematological parameters along with micro-ESR, I/T ratio in diagnosis of neonatal sepsis for initiating early management. Methods: This is a descriptive study consisting of 35 neonates admitted at a sophisticated institute with clinical suspicion of septicaemia along with 40 neonates as the comparison group. The neonatal haematological parameters including total leucocytes count, absolute neutrophil count, immature neutrophil count, I/T ratio, platelet count were measured in all the neonates. Micro-ESR was measured as a bed side test. CRP was also measured using slide agglutination method and the results were compared with turbidimetric method. Blood culture was done as a gold standard test for sepsis. Micro-ESR more than age of the patient in days +3 mm in 1st hour was considered significant for sepsis. I/T ratio more than or equal to 0.2 was considered positive for sepsis. Results: The study revealed that micro-ESR and I/T ratio were significantly higher (p

Objective To analyse seropositivity rates of salmonella with seasonal variations in the population of Taxila and the surrounding rural areas. Methods The study was conducted among 760 suspected patients with symptoms of fever, headache, nausea and decreased white blood cells count screened for the typhoid fever. Blood samples collected from the suspected patients were tested for seropositivity by slide agglutination (Widal test) and Immunochromatographic test, i.e . Typhidot. Results From overall 760 suspected patients of typhoid fever only 192 (25.26%) samples were positive for Widal and Typhidot test. The peak seropositivity rates were identified during the months of April–June, while decreased cases were observed from January to March. Age wise distribution of typhoid fever reflected that age groups of 10–15 years and 25–35 years were at higher risks of developing enteric fever with respect to age groups of 5–10 years and 61–70 years, respectively. On gender basis evaluation, females (24.49%) were slightly at low risks of developing typhoid fever than males (25.9%). Conclusions The present study highlights a higher burden of typhoid fever in Taxila and the surrounding areas population that directly reflects the poor hygienic condition and contamination of drinking water. The frequency of typhoid fever fluctuates with seasonal variations as higher rates found during the summer as compared to winter season.

Made available in DSpace on 2015-08-26T19:21:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-03-01. Added 1 bitstream(s) on 2015-08-31T13:04:22Z : No. of bitstreams: 1 S1809-68912015000100068.pdf: 206927 bytes, checksum: 7d280b233d6a1079b32e9935b2ce7f1d (MD5) Foram colhidas 50 amostras de fezes de mutuns do Criadouro Científico e Cultural Poços de Caldas. A amostras foram enriquecidas em meio caldo Tetrationato e Selenito-Cistina e plaqueadas em Salmonella Shigella (SS), Mac Conkey (MC), Endo-C (EC), Verde Brilhante (VB) e Eosina Azul de Metileno (EMB), a 37º C por 24h. Colônias suspeitas de Salmonella spp foram inoculadas em tubos contendo Ágar Tríplice Açúcar Ferro (TSI) e incubadas a 37 ºC por 24 h. Os tubos com crescimento característico foram submetidas ao teste de aglutinação em lâmina com soros polivalentes somático e flagelar. Os meios SS, MC e VB foram os mais eficientes para o cultivo, sendo 6% das amostras, positivas para Salmonella spp. Sabendo-se que as aves são reservatórios importantes de spp e que esta pode representar um alto risco para a saúde humana, há a necessidade de implantação de uma rotina de limpeza dos recintos para evitar contaminação entre os recintos e o consequente carreamento destes micro-organismos, pelos tratadores, até suas residências ou outros recintos. A presença da Salmonella spp em criadouros pode ser responsável pela menor eclodibilidade dos ovos, prejudicando o objetivo da entidade, que visa o estudo e a manutenção das diferentes espécies de aves silvestres. We collected 50 samples of curasow feces from the Scientific and Cultural Breeding Center in the city of Poços de Caldas. The samples were enriched in broth medium Tetrationato and Cystine-selenite and plated on Salmonella Shigella (SS), Mac Conkey (MC), endo-C (EC), Brilliant Green (VB) and Eosyn Methilen Blue EMB, remaining at 37 °C for 24h. Colonies suspected of Salmonella were inoculated in tubes containing Agar Triple Sugar Iron (TSI) and again incubated at 37 ºC for 24h. Tubes with characteristic growth were submitted to slide agglutination test with polyvalent somatic and flagellar serum. The medium SS, MC and VB were the most efficient for growing, and 36% of samples were positive for Salmonella spp. As birds are important reservoirs of Salmonella spp and it may represent a high risk to human health, there is a need to implement a cleaning routine in enclosures avoiding contamination between the enclosures and the consequent entrainment of these micro-organisms, by the keepers until their homes or other venues. The presence of Salmonella in breeding centers may be responsible for lower hatchability of eggs, undermining the purpose of the entity, which is to study and maintain the various birds species. Universidade de São Paulo, USP - Faculdade de Medicina Veterinária e Zootenia, Pirassununga, SP, Brasil Zooparque, Itatiba, SP, Brasil Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Poços de Caldas, MG, Brasil Universidade Estadual Paulista, UNESP, Jaboticabal, SP, Brasil. Universidade Estadual Paulista, Jaboticabal, SP, Brasil.

Graphical abstract, We have developed a new Superagglutination test for serodiagnosis of infectious diseases. It differs from conventional plate/slide agglutination tests (PAT/SAT) by three additional steps: prior staining of serum antibody by adding a dye and addition of diluted biotinylated antiglobulin and avidin in sequence after mixing the antigen with the test serum. The new steps circumvent the problems of false positive and false negative results of PAT/SAT. In serodiagnosis of brucellosis, Superagglutination test had higher positive predictive value and specificity than Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT) and higher negative predictive value and sensitivity than RBPT, STAT, ELISA and Complement Fixation Test (CFT).•Superagglutination is a simple, accurate and economic screening test for infections.•More specificity, sensitivity, positive & negative predictive value than RBPT, STAT.•More sensitivity, negative predictive value than ELISA and Complement Fixation Test.

We analyzed non-serotype b encapsulated Haemophilus influenzae (non-b Hi) isolated from pediatric patients at Chiba Children's Hospital during 2000-2012. Among 3,532 clinical isolates of H. influenzae, there were 57 (1.6%) strains of non-b Hi, 152 (4.3%) of serotype b H. influenzae (Hib), and 3,323 (94.1%) of non-typeable H. influenzae (NTHi). Fifty-seven strains of non-b Hi were serotyped useing the slide agglutination test and PCR. Twenty-nine strains were identified as type e (Hie) and 28 as type f (Hif), and the results according to the slide agglutination test and PCR were completely identical. Whereas 52 of 57 strains (91.2%) were isolated from respiratory specimen, only one Hif strain (1.8%) was isolated from a sterile site. There were 47 (82.4%) β-lactamase-non-producing ampicillin (ABPC)-sensitive strains (BLNAS), 5 (8.8%) β-lactamase-producing strains (BLP), and only 1 (1.8%) β-lactamase-non-producing ABPC-resistant strain (BLNAR). Thus the frequency of non-b Hi was lower than that of Hib. The source of non-b Hi was similar to that of NTHi, which was mainly isolated from respiratory specimen. Antimicrobial resistant pattern of non-b Hi was different from that of Hib in which the frequency of BLP was relatively high, and NTHi in which that of BLNAR was high. An increase of invasive H. influenzae infections caused by NTHi, Hie, and Hif was reported in the countries where Hib vaccine had been widely used. Because it is assumed that invasive non-Hib infection will be predominant in the near future in Japan, serotyping of invasive strains is crucial. Continuous monitoring of distribution of non-b Hi in the clinical isolates of H. influenzae is also important.

A total of 100 meat and poultry products samples were collected from shops and supermarkets in Aswan governorate; including 50 meat products samples and 50 poultry products. Samples were collected to determine the serotypes and antigenic structures of Salmonella isolates in meat and poultry products and to study the correlation between serotypes and type of meat. Salmonella was isolated by conventional methods and serotyping of Salmonella isolates was performed by slide agglutination method using antisera to Salmonella. It was observed that 16 % of samples were positive for Salmonella; 26% (13/50) in meat samples and 6% (3/50) in poultry samples. Serotypes of isolated Salmonella were Salmonella enteritidis 6.25% (1/16), Salmonella newland 18.75% (3/16), Salmonella Kentucky 12.5% (2/16), Salmonella heifa 6.25% (1/16), Salmonella bron 6.25% (1/16), Salmonella rissens 12.5% (2/16), Salmonella fortune 12.5% (2/16), Salmonella agona 6.25% (1/16), Salmonella hessarek 6.25% (1/16), Salmonella hoboken 6.25% (1/16), Salmonella veneziana 6. Meat and poultry products were contaminated with pathogenic Salmonella and the more prevalent serotypes were Salmonella newland, Salmonella rissens, Salmonella fortune, Salmonella Kentucky andthe lesser prevalent isolates were Salmonella enteritidis, Salmonella heifa, Salmonella bron, Salmonella agona, Salmonella hessarek, Salmonella hoboken and Salmonella veneziana. Results showed that minced meat, kofta, liver and gizzard and sheeshtawook were more contaminated with Salmonellae. Meat and poultry products considered an important source of high risk serotypes of Salmonellae for human and hygienic measures should be undertaken to reduce contamination of meat and poultry products with Salmonella.

Young Ae Lim Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea Background: The results of a particular test can be affected by the techniques used for testing. However, limited data is available on the testing techniques used in blood bank laboratories in Korea. The aim of this study was to evaluate the various testing techniques used in blood bank laboratories using the data obtained during the past six years from the Korean external quality assessment (KEQA) of blood bank laboratories. Methods: Data was collected from all KEQA respondents via the KEQA website on the testing techniques used in blood bank laboratories from 2008 to 2013. The survey included questions on ABO grouping, D typing, crossmatching tests, direct antiglobulin tests (DAT), antibody (Ab) screening, and Ab identification (ID) tests. Results: Based on the data obtained from 2008 to 2013 (ABO grouping data obtained from 2011 to 2013), the most frequently used techniques are as follows: slide agglutination (60.7% and 60.8%) for ABO cell typing; tube agglutination (78.2% and 81.2%) for ABO serum typing; slide agglutination (50% and 54.6%) for D typing; tube agglutination (91.9% and 83.8%) for crossmatching tests; tube agglutination (63.6% and 52.8%) for DAT; column agglutination technique (CAT; 74.5% and 89.4%) for Ab screen; and CAT (83.9% and 94.2%) for Ab ID. Conclusions: The findings reveal a steady increase in the use of CAT from 2008 to 2013 for crossmatching tests, DAT, Ab screen, and Ab ID and a decreasing use of the tube agglutination technique for the past six years. Since the slide agglutination technique accounted for a significant percentage of the tests conducted, further education is warranted on the improvement in the techniques used for ABO and D typing. (J Lab Med Qual Assur 2014;36:23-29)

Pullorum disease and fowl typhoid are septicemic avian diseases transmitting through egg by trans-ovarian infections. A series of tests has been performing in breeding flocks of chickens and test plans for proper inspection have been modified by government veterinary institute to control of such diseases. To improve inspection plans, different test methods were compared using fowl typhoid positive samples from a poultry farm located in Jeonbuk state in 2012. Based on first inspection, 11 samples among total 200 samples were positive by rapid slide agglutination (RSA) test and 7 samples among RSA positive samples were finally diagnosed as Salmonella Gallinarum infection by ELISA, bacterial isolation, PCR, and histopathologic examination. In the second inspection, 20 samples among total 100 samples were positive by RSA test. Among RSA positive ones, 19 samples were positive by ELISA, S. Gallinarm were successfully isolated in 3 samples, and 16 samples were positive by PCR in the cecal tonsils where were not successful for bacterial isolation. Based on histopathologic examination, severe inflammation in the 13 cecal tonsils and infiltration of lymphocytes and heterophils in the 11 livers were observed. Therefore, we suggest that bacterial isolation, PCR, and histopathologic examination methods in the third inspection need to be further used in various tissues for correct diagnosis and for final eradication of pullorum disease and fowl typhoid in breeding flocks of chickens.

Background and Objectives Errors in sample identification contribute to patient mismanagement and erroneous administration of blood and blood products. This report describes the rate of sample identification errors over 2 years in a multispecialty hospital in India and possible measures to decrease these errors. Materials and Methods Various measures were taken to reduce the risk of identification errors during sample collection, laboratory processing and administration of blood. The bedside blood grouping method by the slide agglutination technique was also introduced along with other measures in December 2011 as a risk mitigation step to prevent an ABO incompatible transfusion, as well as to provide a method of surveillance for possible errors during transfusion. Results The rate of sample identification errors was 48 and 45 per 1 000 000 among the total tests billed in 2011 and 2012, respectively. In the blood bank alone, the sample identification error rate was 0·96 in 2011 and 0·46 in 2012 per 1000 bags of blood and blood components issued after the various steps to prevent such errors in the blood bank were introduced. 81% of these errors (26 out of 32) have been reported in the inpatient setting. 15·6% (5 out of 32) were repeat errors made by the same technicians. Conclusions Among the various measures used to reduce sample identification errors, bedside blood grouping allows prevention of ABO incompatible transfusions when performed by trained technicians and may also be used as a method of active surveillance for sample identification errors in hospitals.

Background: In Ghana, a blood group and rhesus type test is one of the essential recommended screening tests for women during antenatal care since blood transfusion is a key intervention for haemorrhage. We estimated the spatial accessibility to health facilities for blood group and type point-of-care (POC) testing in the Upper East Region (UER), Ghana. Methods: We assembled the attributes and spatial data of hospitals, clinics, and medical laboratories providing blood group and rhesus type POC testing in the UER. We also obtained the spatial data of all the 131 towns, and 94 health centres and community-based health planning and services (CHPS) compounds providing maternal healthcare in the region. We further obtained the topographical data of the region, and travel time estimated using an assumed tricycle speed of 20 km/h. We employed ArcGIS 10.5 to estimate the distance and travel time and locations with poor spatial access identified for priority improvement. Findings: In all, blood group and rhesus type POC testing was available in 18 health facilities comprising eight public hospitals and six health centres, one private hospital, and three medical laboratories used as referral points by neighbouring health centres and CHPS compounds without the service. Of the 94 health centres and CHPS compounds, 51.1% (48/94) and 66.4% (87/131) of the towns were within a 10 km range to a facility providing blood group and rhesus type testing service. The estimated mean distance to a health facility for blood group and rhesus POC testing was 8.9 &plusmn, 4.1 km, whilst the mean travel time was 17.8 &plusmn, 8.3 min. Builsa South district recorded the longest mean distance (25.6 &plusmn, 7.4 km), whilst Bongo district recorded the shortest (3.1 &plusmn, 1.9 km). The spatial autocorrelation results showed the health facilities providing blood group and rhesus type POC testing were randomly distributed in the region (Moran Index = 0.29, z-score = 1.37, p = 0.17). Conclusion: This study enabled the identification of district variations in spatial accessibility to blood group and rhesus type POC testing in the region for policy decisions. We urge the health authorities in Ghana to evaluate and implement recommended POC tests such as slide agglutination tests for blood group and rhesus type testing in resource-limited settings.

Agglutination is the clumping of antigenic particles by antibodies. Several diagnostic kits for infectious diseases of animals and humans, based on slide agglutination/plate agglutination tests like the Rose Bengal Plate Test ( RBPT) for diagnosis of brucellosis are used worldwide. False negative and false positive results are commonly encountered in these conventional agglutination tests. Simple, cost effective modifications can help in circumventing these problems. The novelSuperagglutinationTest reported here is a modified slide / plate agglutination test. False negative results due to smaller clumps formed by low titer of antibodies in serum are minimized by the addition of biotinylated antiglobulin followed by Avidin which forms easily detectable larger clumps. Similarly, prior staining of serum antibodies with a dye helps in differentiating a specific agglutinate formed by both antigen and antibody, from a non -specific aggregate of antigen alone that leads to false positive results.Superagglutinationis more sensitive than the current agglutination tests and agglutination based diagnostic kits. The modification steps are easy to perform and give a more accurate diagnosis without much increase in the cost of