FRTBI is associated with significant functional decline and increased resource utilisation with almost half of the patients having had prior ED visits or hospitalisation. Future studies should focus on falls risk assessment and interventions for high-risk older adults prior to discharge from ED and hospital, and its impact on readmissions due to FRTBI.

Thin and thick blood film microscopy are the "gold standard" for malaria diagnosis. In recent years, there have been important developments in malaria diagnostic tests including fluorescence microscopy of malaria parasites stained with acridine orange, dipstick immunoassays that detect species-specific parasite antigens, and more recently, detection of parasite nucleic acids after amplification by PCR. With some of these methods, sensitivities and specificities approaching and even exceeding those of the thin and thick film can be attained. In particular, PCR-based tests for plasmodium DNA or RNA are more sensitive and specific than other tests for malarial parasites. A specific application for PCR diagnosis of malaria could be blood donor screening. Clinical trials of blood donor sreening for malarial parasites by PCR are being conducted, in which pooled donor samples are screened to increase efficiency and reduce costs. Some of the new diagnostic methods may have specific applications in particular settings, depending on the purpose and location of testing, and other factors such as cost, desired sensitivity and specificity, speed and ease of use.

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Background/aimMethicillin-resistant Staphylococcus aureus (MRSA) is one of the most common multidrug-resistant organisms in healthcare settings worldwide, but little is known about MRSA transmission outside of acute healthcare settings especially in Asia. We describe the methods for a prospective longitudinal study of MRSA prevalence and transmission.MethodsMRSA-colonized individuals were identified from MRSA admission screening at two tertiary hospitals and recruited together with their household contacts. Participants submitted self-collected nasal, axilla and groin (NAG) swabs by mail for MRSA culture at baseline and monthly thereafter for 6 months. A comparison group of households of MRSA-negative patients provided swab samples at one time point. In a validation sub-study, separate swabs from each site were collected from randomly selected individuals, to compare MRSA detection rates between swab sites, and between samples collected by participants versus those collected by trained research staff. Information on each participant’s demographic information, medical status and medical history, past healthcare facilities usage and contacts, and personal interactions with others were collected using a self-administered questionnaire.Discussion/conclusionUnderstanding the dynamics of MRSA persistence and transmission in the community is crucial to devising and evaluating successful MRSA control strategies. Close contact with MRSA colonized patients may to be important for MRSA persistence in the community; evidence from this study on the extent of community MRSA could inform the development of household- or community-based interventions to reduce MRSA colonization of close contacts and subsequent re-introduction of MRSA into healthcare settings. Analysis of longitudinal data using whole-genome sequencing will yield further information regarding MRSA transmission within households, with significant implications for MRSA infection control outside acute hospital settings.