{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:34:25Z","timestamp":1762079665682},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T00:00:00Z","timestamp":1541635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p><jats:italic>Tropheryma whipplei<\/jats:italic>, the causative agent of Whipple's disease, can also be identified in stool samples of humans without systemic disease. It is much more frequently detected in human stool samples in tropical environments than in industrialized countries. <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\u2010screening has been applied for point prevalence studies and environmental assessments in tropical settings, but results depend on the applied assay. We compared one commercial <jats:styled-content style=\"fixed-case\">qPCR<\/jats:styled-content> kit with two well\u2010described in\u2010house assays for detection of <jats:italic>T.\u00a0whipplei<\/jats:italic> from stool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Residual materials from nucleic acid extractions of stool samples from two groups with presumably different prevalences and increased likelihood of being colonized or infected by <jats:italic>T.\u00a0whipplei<\/jats:italic> were tested. One group comprised 300 samples from study participants from western Africa (group 1); the second group was of 300 returnees from tropical deployments (group 2). Each sample was assessed with all three <jats:styled-content style=\"fixed-case\">qPCR<\/jats:styled-content> assays. Cycle threshold (<jats:italic>C<\/jats:italic><jats:sub>t<\/jats:sub>) values were descriptively compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based solely on mathematical modeling, the three <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> assays showed considerably different detection rates of <jats:italic>T.\u00a0whipplei <\/jats:italic><jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> in stool samples (kappa 0.67 (95% confidence interval [0.60, 0.73])). Considering the calculated test characteristics, prevalence of 28.3% for group 1 and 5.0% for group 2 was estimated. Discordant test results were associated with later <jats:italic>C<\/jats:italic><jats:sub>t<\/jats:sub> values. The study did not validate the assays for the detection of <jats:italic>T.\u00a0whipplei<\/jats:italic> in Whipple's disease and for diagnostic purposes since clinical specificity and sensitivity were not investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In spite of the observed diagnostic uncertainty, <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\u2010based screening approaches can be used for epidemiological purposes and environmental samples to define the source and reservoir in resource\u2010limited tropical settings if prevalence is calculated using diagnostic accuracy\u2010adjusted methods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13172","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T18:19:54Z","timestamp":1540232394000},"page":"101-108","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Detection of 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