# Field Evaluation of Mobile Molecular Differential Tests in DRC and Nigeria

## TL;DR

A mobile lab tested fevers in DRC and Nigeria, finding malaria and other infections, highlighting underdiagnosed diseases in resource-limited areas.

## Contribution

A mobile molecular testing approach was field-tested in two African regions to improve differential diagnosis of febrile illnesses.

## Key findings

- Plasmodium falciparum was detected in 23% of DRC cases and 47% of Nigerian cases.
- Salmonella enterica was detected in only one case in each cohort.
- The study suggests circulating aetiological agents in febrile patients in Sub-Saharan Africa are underestimated.

## Abstract

Accurate and timely differential diagnoses are a challenge for health care, particularly in infrastructure-poor settings.

To investigate fevers of unknown origin in Africa, a mobile suitcase laboratory was deployed to DRC and Southwest Nigeria to support the control of the 2018–2020 Ebola virus disease outbreak in North-Kivu and Ituri provinces (DRC) and to provide a point-of-need solution for malaria confirmation during the dry season, respectively.

In DRC, the samples were tested for Ebola virus and the differentials Plasmodium falciparum, Salmonella enterica, yellow fever virus, Dengue virus, and chikungunya virus. In Southwest Nigeria, the samples were not tested for Ebola virus but were tested for the same differentials and additionally for Rickettsia spp., Leptospira, and Streptococcus pneumoniae. Plasmodium falciparum was detected in 23% (n = 192) and 47% (n = 88) of cases, respectively, and Salmonella enterica was detected in only 1 case in each cohort.

The etiological agents circulating in febrile patients in Sub-Saharan Africa and the true incidence of neglected tropical diseases are still underestimated.

Field testing of a differential molecular test panel in DRC and Nigeria indicates possibly circulating aetiological agents in febrile patients in Sub-Saharan Africa are still underestimated.

Graphical AbstractThis graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/infective-endocarditis-and-antimicrobial-timing-a-case-for-delay?utm_campaign=tidbitlinkshare&utm_source=IO

This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/infective-endocarditis-and-antimicrobial-timing-a-case-for-delay?utm_campaign=tidbitlinkshare&utm_source=IO