Summary Non-treponemal tests such as the rapid plasma reagin (RPR) assay are mainstays of syphilis diagnosis, but false-positive tests are common. We identified false-positive RPR titers in 8.2% of patients with malaria due to Plasmodium vivax in northern Peru. Similar rates were not detected in patients with other acute febrile illnesses.

Multicenter collaborative networks are essential for advancing research and improving clinical care for a variety of conditions. Research networks are particularly important for central nervous system infections, which remain difficult to study due to their sporadic occurrence and requirement for collection and testing of cerebrospinal fluid. Establishment of long-term research networks in resource-limited areas also facilitates diagnostic capacity building, surveillance for emerging pathogens, and provision of appropriate treatment where needed. We review our experience developing a research network for encephalitis among twelve hospitals in five Peruvian cities since 2009. We provide practical suggestions to aid other groups interested in advancing research on central nervous system infections in resource-limited areas.

Volume 37 Number 12 LABMEDICINE 751 the ALIMS was implemented with the following procedures: (1) urine, vaginal swabs, and blood samples were codified by barcode labels at collection; (2) samples received at NMRCD were entered into the ALIMS using a digital barcode reader; (3) ALIMS created a worksheet for each test to be performed; (4) results from the automated tests, EIAs, and PCR were sent electronically to the ALIMS, which verified the validity of the tests using the manufacturers' criteria and also identified those samples that needed repeat or confirmation testing; and (5) the ALIMS generated a complete table of results using the initial barcode entry for each participant (Figure 2).For the implementation of this automated system, 3 desktop computers were installed in the laboratory and networked with a main computer outside the laboratory. The ALIMS was installed on all 4 computers and each computer had a barcode reader connected. The desktop computer at the sample reception unit had a barcode label printer, which generated the barcode labels to identify each of the samples and their corresponding aliquots.The ALIMS system was connected to Freezerworks 5 (Dataworks Development), a program built in Microsoft Access and structured according to the needs of the laboratory users to assure accessibility, security, ease of use, and to provide an intuitive interface. This system permits data importation from the Freezerworks sample database. Once imported into the ALIMS, worksheets are generated for each test according to sample type. For this study, we used worksheets for the HIV-1 and HSV-2 immunoassays, Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) PCR, and the detection of antibodies for syphilis. Once the worksheets were generated, testing was performed using the corresponding manufacturer-recommended technique (HSV-2, Focus Technologies; HIV-1, Biomerieux and BioRad; PCR CT/NG, Roche Diagnostics). For tests using microplate readers (Molecular Devices with Soft-max software), HIV-1 EIA, HSV-2 EIA and CT/NG PCR, the machines were connected directly to the ALIMS computers. Thus, once the test was completed, all of the optical densities from the readers Figure 1_General flowchart for the processing of samples processing prior to the implementation and utilization of the ALIMS. The manual processes include the entering of identification codes for the samples, and the entering of the aliquots to the Freezerworks system for sample storage. were automatically transferred into the ALIMS, which then assigned results to each of the samples. Discordant results or results in the previously established grey zone were automatically assigned a new worksheet repetition according to the study protocol. As the Syphilis RPR test (RPRnosticon, Biomerieux) was manually performed, these results were entered manually. Positive results were then titrated and entered to a new worksheet for the TPPA (Treponema pallidum particle agglutination) confirmatory test (Fujirebio); results from TPPA were also entered manually into...

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