Disease Areas & Products

Fever of Unknown Origin

Fever of unknown origin (FUO) is defined as fever at or above 101°F (38.3°C) for 3 weeks or more that remains undiagnosed after 3 days of in-hospital testing or during two or more outpatient visits. Cause of fever can be external due to microorganisms (bacteria, virus, and parasites) or internal (rheumatoid arthritis) due to inflammation, cancer, or an allergy. A thorough history, physical examination, and standard laboratory testing remain the basis of the initial evaluation of the patient with FUO.

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Pathogen causing fevers of unknown origin

The risks of incorrect diagnosis

There is no standard diagnostic approach to fever of unknown origin. FUO requires a focused FUO-relevant history, physical examination, and selective nonspecific laboratory tests rather than excessive overtesting. FUO remain a difficult diagnostic challenge because over 200 disorders are in the differential diagnosis.

Diagnostic Approach to Classic Fever of Unknown Origin

The Fever of Unknown Origin work-up should be symptom (history) and sign (physical examination) driven. Symptom & Sign Driven
Malignant/neoplastic disorders, infectious diseases and rheumatic or inflammatory disorders – all are associated with category of fever. History & Physical Clues
Organ Involvement Each disorder has a characteristic pattern of organ involvement that suggests/limits diagnostic possibilities.

Symptoms & Diagnosis

The correct diagnosis of microbiological infection in a short time is difficult due to series of tests required for different parasites. Moreover, all these diagnostic tests needed to be done separately for different diseases which will increase the time and cost to patients with increased risk for patient health due to delay in treatment. There is a definite need for rapid, precise, and cost-effective measurement of disease marker analytes for early diagnosis of illness.

Malaria

FUO - Microorganisms

Malaria

Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito carrying the Plasmodium parasite. Once the parasites are inside your body, they travel to the liver, where they mature. Within 48 to 72 hours, the parasites inside the red blood cells multiply, causing the infected cells to burst open continuing to infect red blood cells, resulting in symptoms that occur in cycles that last two to three days at a time.

Microscopy and RDT’s are not able to track down parasites in low-transmission settings

Malaria Deaths
WHO strategy
Sensitivity

Symptoms & diagnosis

About a million cases of malaria are reported every year in India. The symptoms of malaria typically develop within 10 days to 4 weeks following the infection. In some cases, symptoms may not develop for several months. Common symptoms may include shaking chills, high fever, profuse sweating, convulsions, enlarged spleen or liver.

A quick diagnosis leads to life saving treatments.

A paradigm shift in diagnosis

The revolutionary Multiplex Fever Panel being developed by NGIVD will lead to a paradigm shift in how fevers are being diagnosed. The Multiplex Fever Panel will lay the foundation for a basic test to be done for rapid, sensitive and specific diagnosis of these fever related diseases in a cost-effective manner with a simultaneous identification of mixed infections.

About 13 molecular markers for seven diseases (Malaria, Typhoid, Para-typhoid, Chikungunya, Dengue, Leptospira) will be used in fever panel.

Key features & benefits

  • Multiplex test for rapid detection of Malaria, Dengue, Chikungunya, Typhoid, Hepatitis A and Hepatitis E
  • Simple format to collect samples – dried blood spot
  • High thru-put of up to 300 tests per day
  • Cost per test is 50% to 60% of simplex test combination

Current Status

  • Lab development started
  • Time to market – 18 to 20 months

Overview

Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito carrying the Plasmodium parasite. Once the parasites are inside your body, they travel to the liver, where they mature. Within 48 to 72 hours, the parasites inside the red blood cells multiply, causing the infected cells to burst open continuing to infect red blood cells, resulting in symptoms that occur in cycles that last two to three days at a time.

Symptoms & diagnosis

About a million cases of malaria are reported every year in India. The symptoms of malaria typically develop within 10 days to 4 weeks following the infection. In some cases, symptoms may not develop for several months. Common symptoms may include shaking chills, high fever, profuse sweating, convulsions, enlarged spleen or liver.

A quick diagnosis leads to life saving treatments.

Malaria-LAMP workflow

The LoopampTM workflow allows for an easy DNA extraction and the preparation of the test involves a few steps without any additional equipment. Reagent storage and shipment at room temperature and the excellent test performance make molecular pathogen testing available in rural areas with limited settings.

NGIVD has partnered with Human Diagnostics Worldwide, Germany to exclusively bring this product to India.

  • High specificity and sensitivity
  • Very short turnaround times
  • Simple processing
  • High degree of robustness
  • Easy result interpretation, either visually (HumaLoop) or by means of a turbidimeter (HumaTurb system)

Best Performance

High reliability ensured by best performance.

  • Sensitivity of 96 to 100 % and specificity of 97 to 100 %
  • Detection limit of 1 parasite / μl
  • Differentiation between Plasmodium pan species, P. falciparum and P. vivax
  • Listed in the WHO Policy brief on malaria diagnostic in low-transmission settings
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