title: Evaluation of anatomically designed flocked rectal swabs for molecular detection of enteric pathogens in children admitted to hospital with severe gastroenteritis in Botswana.
abstract: Two-hundred eighty matched bulk stool and anatomically designed flocked rectal swab samples were collected from children admitted to the hospital with acute diarrhea in Botswana. Their parents were asked about the acceptability of the swab collection method compared with bulk stool sampling. All samples underwent identical testing with a validated 15-target (9 bacterial, 3 viral, and 3 parasite) commercial multiplex PCR assay. The flocked swabs had a 12% higher yield for bacterial pathogen targets (241 versus 212; P = 0.003) compared with that of stool samples, as well as similar yields for viral targets (110 versus 113; P = 0.701) and parasite targets (59 versus 65; P = 0.345). One hundred sixty-four of the flocked swab-stool pairs were also tested with separate laboratory-developed bacterial and viral multiplex assays, and the flocked rectal swabs had a performance that was similar to that seen with commercial assay testing. Almost all parents/guardians found the swabs acceptable. Flocked rectal swabs significantly facilitate the molecular diagnosis of diarrheal disease in children.
authors.affiliation: McMaster University, Hamilton, Ontario, Canada Botswana UPenn Partnership, Gaborone, Botswana University of Botswana, Gaborone, Botswana goldfarb@mcmaster.ca.
authors.forename: David M
authors.initials: DM
authors.lastname: Goldfarb
authors.affiliation: Botswana UPenn Partnership, Gaborone, Botswana Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA University of Botswana, Gaborone, Botswana.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Steenhoff
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Pernica
authors.affiliation: McMaster University, Hamilton, Ontario, Canada St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Chong
authors.affiliation: McMaster University, Hamilton, Ontario, Canada St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Luinstra
authors.affiliation: Botswana National Health Laboratory, Gaborone, Botswana.
authors.forename: Margaret
authors.initials: M
authors.lastname: Mokomane
authors.affiliation: University of Botswana, Gaborone, Botswana.
authors.forename: Loeto
authors.initials: L
authors.lastname: Mazhani
authors.affiliation: University of Botswana, Gaborone, Botswana.
authors.forename: Isaac
authors.initials: I
authors.lastname: Quaye
authors.affiliation: Botswana UPenn Partnership, Gaborone, Botswana.
authors.forename: Irene
authors.initials: I
authors.lastname: Goercke
authors.affiliation: McMaster University, Hamilton, Ontario, Canada St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Mahony
authors.affiliation: McMaster University, Hamilton, Ontario, Canada St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors.forename: Marek
authors.initials: M
authors.lastname: Smieja
mesh_terms: D001902:Botswana; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000175:diagnosis; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis*; D006761:Hospitals; D006801:Humans; D008297:Male; D008828:Microbiological Techniques / Q000379:methods*; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology* / Q000469:parasitology / Q000821:virology*; D013048:Specimen Handling / Q000379:methods*