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  1. Article ; Online: The impact of stroke on spousal and family income: a difference-in-difference study from Swedish national registries.

    Labori, Frida / Persson, Josefine / Svensson, Mikael / Bonander, Carl

    Topics in stroke rehabilitation

    2023  Volume 31, Issue 4, Page(s) 381–389

    Abstract: Aim: To investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke.: Methods: The study ... ...

    Abstract Aim: To investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke.
    Methods: The study population consists of spouses aged ≤ 60 during the year of their partner's stroke event. Each spouse was matched to four reference individuals. This longitudinal registry data covers spouses and a reference population between 2005 and 2016. We use difference-in-differences to estimate the impact on individual income from paid work, disposable individual income, and disposable family income.
    Results: The primary analysis shows a small and statistically insignificant decrease on spouses' individual income from paid work and disposable individual income. In the subgroup analysis based on mRS, the largest effect is seen in mRS 4-5, where spouses' individual income from paid work and disposable individual income increases after their partner's stroke. Further, younger female spouses' individual income from paid work decreases by 1 614 EUR (
    Conclusion: The financial consequences are small in the overall population of spouses. However, for some subgroups, younger women, and spouses of persons with stroke and mRS 4-5, the financial consequences are more prominent.
    MeSH term(s) Humans ; Female ; Stroke/epidemiology ; Stroke/therapy ; Sweden/epidemiology ; Spouses
    Language English
    Publishing date 2023-10-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 1213112-x
    ISSN 1945-5119 ; 1074-9357
    ISSN (online) 1945-5119
    ISSN 1074-9357
    DOI 10.1080/10749357.2023.2269674
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Long-term effects on healthcare utilisation among spouses of persons with stroke.

    Labori, Frida / Bonander, Carl / Svensson, Mikael / Persson, Josefine

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 1298

    Abstract: Background: Stroke is a common and costly disease affecting the person with stroke and their relatives. If the negative effect on the health of informal caregivers to a person with stroke translates into an increased healthcare consumption has not yet ... ...

    Abstract Background: Stroke is a common and costly disease affecting the person with stroke and their relatives. If the negative effect on the health of informal caregivers to a person with stroke translates into an increased healthcare consumption has not yet been studied. Further, the importance of including costs and health consequences of informal caregiving in health economic evaluation supporting decision-making is an ongoing discussion. Therefore, this study aims to estimate the long-term effect on healthcare utilisation among spouses of persons with a first-ever stroke.
    Method: The study population consists of spouses of persons with first-ever stroke events in 2010-2011 and a reference population matched on age, sex and municipality of residence. We have access to information on healthcare utilisation five years before and five years after the stroke event for the whole study population. Using a difference-in-difference approach, the main analysis estimates the effects on primary and specialist outpatient care visits and days with inpatient care per year. Further, we analyse the healthcare utilisation among spouses depending on the modified Rankin Scale (mRS) of the person with stroke.
    Results: Our main analysis indicates that spouses have slightly more days with inpatient care five years after the stroke event than the reference population (p = 0.03). In contrast, spouses have fewer primary and specialist outpatient care visits than the reference population following the stroke event. In the analysis where spouses' healthcare utilisation is analysed according to the mRS status of the person with stroke, we identify the most notable change in the number of visits to specialist outpatient and days with inpatient care among spouses of persons with mRS 3 (dependency in daily activities).
    Conclusion: Our study suggests that being the spouse of a person with stroke has minor effects on healthcare utilisation. Further, healthcare utilisation is most affected among the spouses of persons with stroke and dependency in daily activities (mRS 3). According to our results, it does not seem vital to include spouses of persons with stroke healthcare utilisation in health economic evaluations.
    MeSH term(s) Humans ; Spouses ; Stroke/therapy ; Patient Acceptance of Health Care ; Costs and Cost Analysis ; Caregivers
    Language English
    Publishing date 2023-11-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-10286-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Clinical follow-up of left atrial appendage occlusion in patients with atrial fibrillation ineligible of oral anticoagulation treatment-a systematic review and meta-analysis.

    Labori, Frida / Bonander, Carl / Persson, Josefine / Svensson, Mikael

    Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

    2021  Volume 61, Issue 2, Page(s) 215–225

    Abstract: Purpose: The recommended stroke prevention for patients with atrial fibrillation (AF) and increased risk of ischemic stroke is oral anticoagulation (OAC). Parts of the patient population are not eligible due to contraindication, and percutaneous left ... ...

    Abstract Purpose: The recommended stroke prevention for patients with atrial fibrillation (AF) and increased risk of ischemic stroke is oral anticoagulation (OAC). Parts of the patient population are not eligible due to contraindication, and percutaneous left atrial occlusion (LAAO) can then be a preventive treatment option. The aim of this systematic review and meta-analysis is to estimate the long-term clinical effectiveness of LAAO as stroke prevention in patients with AF, increased risk of ischemic stroke, and contraindication to OAC.
    Methods: We performed a systematic review and meta-analysis, using Poisson random effect models, to estimate the incidence rate (events per 100 patient-years) of ischemic stroke, transient ischemic attack, major bleeding, and all-cause death after LAAO treatment. We also calculated the risk reduction of ischemic stroke with LAAO compared with no stroke prevention estimated through a predicted risk in an untreated population (5.5 per 100 patient-years).
    Results: We included 29 observational studies in our meta-analysis, including 7 951 individuals and 12 211 patient-years. The mean CHA
    Conclusions: Our results suggest that LAAO is effective as stroke prevention for patients with AF, increased risk of stroke, and contraindication to oral anticoagulation.
    MeSH term(s) Anticoagulants ; Atrial Appendage/diagnostic imaging ; Atrial Appendage/surgery ; Atrial Fibrillation/drug therapy ; Follow-Up Studies ; Humans ; Observational Studies as Topic ; Stroke/epidemiology ; Stroke/prevention & control ; Treatment Outcome
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-02-13
    Publishing country Netherlands
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 1329179-8
    ISSN 1572-8595 ; 1383-875X
    ISSN (online) 1572-8595
    ISSN 1383-875X
    DOI 10.1007/s10840-021-00953-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Employment transitions for spouses of stroke survivors: evidence from Swedish national registries.

    Persson, Josefine / Hensing, Gunnel / Bonander, Carl

    BMC public health

    2020  Volume 20, Issue 1, Page(s) 1522

    Abstract: Background: The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on ... ...

    Abstract Background: The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses' employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect.
    Method: Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1818 spouses of first ever stroke survivors during 2010 and 2011, and 7399 matched controls that were employed or unemployed during 5 years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset.
    Results: Employed spouses prior stroke onset reduced their employment by - 1.3 percentage points (95% CI, - 2.4, - 0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset.
    Conclusion: The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.
    MeSH term(s) Cohort Studies ; Employment ; Female ; Humans ; Male ; Middle Aged ; Registries ; Spouses ; Stroke/epidemiology ; Survivors ; Sweden/epidemiology
    Language English
    Publishing date 2020-10-07
    Publishing country England
    Document type Journal Article
    ISSN 1471-2458
    ISSN (online) 1471-2458
    DOI 10.1186/s12889-020-09625-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Hospital costs and health-related quality of life from complications after esophagectomy.

    Löfgren, Anna / Åkesson, Oscar / Johansson, Jan / Persson, Josefine

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2020  Volume 47, Issue 5, Page(s) 1042–1047

    Abstract: Background: Approximately 50% of all patients undergoing esophagectomy experience complications. This paper estimates the costs due to complications after esophagectomy in a Swedish context.: Material and methods: The Swedish National Register for ... ...

    Abstract Background: Approximately 50% of all patients undergoing esophagectomy experience complications. This paper estimates the costs due to complications after esophagectomy in a Swedish context.
    Material and methods: The Swedish National Register for Esophageal and Gastric Cancer (NREV) and the Healthcare Consumption Register in Region Skåne (RSVD) were crossmatched for patients undergoing esophagectomy between 2010 and 2015 in Region Skåne, Sweden (n = 132). Multivariable linear regression analysis was performed on the logarithm of total healthcare cost. HRQoL was presented descriptively.
    Results: The mean total healthcare costs were 335,016 SEK (€33,502) for the group with no complications and 438,320 SEK (€43,832) and 808,461 SEK (€80,846) for minor and major complications (p < 0.001), respectively. Pneumonia (p < 0.001), laryngeal nerve paresis (p = 0.002) and other complications (p < 0.001) showed significant associations with increased healthcare cost. No significant difference was found in QALY-weights between the complication grades. Patients that underwent esophagectomy reported poorer HRQoL than the scores valued by the general background population.
    Conclusion: Complications following esophagectomy incrementally increase the healthcare costs, where more severe complications led to higher healthcare costs. The severity of complications did not affect the mean QALY-weights.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Esophagectomy/adverse effects ; Female ; Hospital Costs ; Humans ; Male ; Middle Aged ; Postoperative Complications/economics ; Postoperative Complications/psychology ; Quality of Life ; Quality-Adjusted Life Years
    Language English
    Publishing date 2020-09-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2020.09.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Societal costs of ovarian cancer in a population-based cohort - a cost of illness analysis.

    Palmqvist, Charlotte / Persson, Josefine / Albertsson, Per / Dahm-Kähler, Pernilla / Johansson, Mia

    Acta oncologica (Stockholm, Sweden)

    2022  Volume 61, Issue 11, Page(s) 1369–1376

    Abstract: Background: The societal cost associated with ovarian cancer (OC) is not well known. Increasing costs for new treatments and/or the impact of organizational changes motivates these costs to be described and communicated. This study aims to evaluate the ... ...

    Abstract Background: The societal cost associated with ovarian cancer (OC) is not well known. Increasing costs for new treatments and/or the impact of organizational changes motivates these costs to be described and communicated. This study aims to evaluate the cost of illness of OC in a population-based cohort.
    Material and methods: All patients diagnosed with ovarian, fallopian tube, primary peritoneal cancer, and serous cancer of undesignated primary site (UPS) in 2011-2012 were followed for six years. Direct costs, i.e., costs for health care expenditures, were gathered from the regional healthcare database. Information on indirect costs, i.e., costs of loss of production due to sick leave, was retrieved from Statistics Sweden. Sub-group analyses were conducted regarding stage, income levels, residential area, and diagnosis.
    Results: The cost of illness for all stages during the six years of follow-up was €201,086 per patient, where indirect costs constituted 43.7%. The mean cost of illness per year per patient for all stages was €33,514. Direct costs were higher in advanced stages compared to early stages for every year from diagnosis. During the first two years, there were no differences in indirect costs between early and advanced stages. However, during the third year there was a difference with higher indirect costs in advanced stages. There was no difference in direct costs depending on income levels. Regarding residential area, there was a difference in the outpatient cost during the index and second year with higher costs when chemotherapy and follow-up were provided at county hospitals, compared to at the tertiary hospital.
    Conclusions: Indirect costs constituted a large part of the cost of illness over 6 years from diagnosis. This could indicate that even though treatment costs can be expected to rise with the introduction of new therapies, the societal cost may decrease when survival increase.
    Language English
    Publishing date 2022-11-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 896449-x
    ISSN 1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
    ISSN (online) 1651-226X
    ISSN 0349-652X ; 0284-186X ; 1100-1704
    DOI 10.1080/0284186X.2022.2140015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Cost-effectiveness analysis of voice rehabilitation for patients with laryngeal cancer: a randomized controlled study.

    Johansson, Mia / Finizia, Caterina / Persson, Josefine / Tuomi, Lisa

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

    2020  Volume 28, Issue 11, Page(s) 5203–5211

    Abstract: Introduction: Voice problems are common following radiotherapy for laryngeal cancer. Few studies exist covering the effect of voice rehabilitation, and no previous studies exist regarding the cost of said rehabilitation. This randomized controlled study ...

    Abstract Introduction: Voice problems are common following radiotherapy for laryngeal cancer. Few studies exist covering the effect of voice rehabilitation, and no previous studies exist regarding the cost of said rehabilitation. This randomized controlled study aimed to analyze the cost-effectiveness of voice rehabilitation after radiotherapy for patients with laryngeal cancer.
    Material and methods: A total of 66 patients with laryngeal cancer with follow-up data 12 months post-radiotherapy were included. Patients were randomized into receiving either voice rehabilitation (n = 32) or no voice rehabilitation (n = 34). The patient outcome was measured as quality-adjusted life years (QALYs). The index range between 0 and 1, where 0 equals death and 1 represents perfect health. The QALYs were assessed with the European Organization for Research and Treatment of Cancer questionnaire QLQ-C30 mapped to EuroQoL 5 Dimension values. The cost of rehabilitation and other healthcare visits was derived from hospital systems. The patients reported the total amount of sick leave days during the first 12 months following radiotherapy. The cost-effectiveness of the voice rehabilitation was compared with no rehabilitation intervention based on the incremental cost-effectiveness ratio.
    Results: The cost per gained QALY with voice rehabilitation compared to no rehabilitation from a societal perspective was - 27,594 € (SEK - 250,852) which indicates that the voice rehabilitation is a cost-saving alternative compared to no rehabilitation due to lower costs and a slightly better health outcome. From a healthcare perspective, the voice rehabilitation indicates a cost 60,800 € (SEK 552,725) per gained QALY.
    Conclusion: From a societal perspective, i.e., including the costs of production loss, voice rehabilitation compared to no voice rehabilitation following radiotherapy for laryngeal cancer seems to be cost-saving. When analyzing only the healthcare costs in relation to health outcomes, voice rehabilitation indicates an incremental cost of 60,800 € per gained QALY, which is just above the threshold of the maximum willingness to pay level.
    MeSH term(s) Adult ; Cost-Benefit Analysis ; Female ; Health Care Costs ; Humans ; Laryngeal Neoplasms/economics ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/radiotherapy ; Laryngeal Neoplasms/rehabilitation ; Male ; Middle Aged ; Quality-Adjusted Life Years ; Radiation Injuries/etiology ; Radiation Injuries/pathology ; Radiation Injuries/rehabilitation ; Surveys and Questionnaires ; Sweden ; Voice Disorders/etiology ; Voice Disorders/pathology ; Voice Disorders/rehabilitation
    Language English
    Publishing date 2020-02-20
    Publishing country Germany
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1134446-5
    ISSN 1433-7339 ; 0941-4355
    ISSN (online) 1433-7339
    ISSN 0941-4355
    DOI 10.1007/s00520-020-05362-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Cost-effectiveness analysis of left atrial appendage occlusion in patients with atrial fibrillation and contraindication to oral anticoagulation.

    Labori, Frida / Persson, Josefine / Bonander, Carl / Jood, Katarina / Svensson, Mikael

    European heart journal

    2021  Volume 43, Issue 13, Page(s) 1348–1356

    Abstract: Aims: This study aims to estimate the cost-effectiveness of percutaneous left atrial appendage occlusion (LAAO) compared to standard stroke prevention care for patients with atrial fibrillation (AF) and contraindication to oral anticoagulation (OAC) in ... ...

    Abstract Aims: This study aims to estimate the cost-effectiveness of percutaneous left atrial appendage occlusion (LAAO) compared to standard stroke prevention care for patients with atrial fibrillation (AF) and contraindication to oral anticoagulation (OAC) in a Swedish healthcare and public sector perspective.
    Methods and results: We used a combined decision tree and cohort Markov model to estimate costs and quality-adjusted life-years (QALYs) over a lifetime horizon with LAAO compared to standard of care where the treatment effect is based on a recent meta-analysis. According to our analysis, LAAO gives more QALYs than standard of care (7.11 vs. 6.12). Furthermore, LAAO treatment is related to the first-year cost of 14 984 Euro (EUR) and higher average healthcare costs over the lifetime by about 4010 EUR, which gives an incremental cost-effectiveness ratio of LAAO vs. standard of care at 4047 EUR per gained QALY. From a public sector perspective, LAAO reduces average costs due to substantial reductions in long-term care and, thus, implies that LAAO is dominant from a public sector perspective (lower average costs and better health outcomes).
    Conclusion: From both Swedish healthcare and public sector perspectives, LAAO can be considered cost-effective compared to standard of care for individuals with AF and contraindication to OAC. However, these results must be confirmed in health economic evaluations alongside the ongoing randomized clinical trials.
    Key question: Is left atrial appendage occlusion (LAAO) cost-effective for patients with atrial fibrillation (AF) and contraindication to oral anticoagulation (OAC) compared to the standard of care from a Swedish healthcare and public sector perspective?
    Key finding: LAAO is associated with lower cost than the standard of care from a public sector perspective and an incremental cost of 4010 Euro from a healthcare perspective. Furthermore, LAAO is related to better health outcomes than the standard of care.
    Take home message: Treatment with LAAO among individuals with AF and contraindication to OAC can be considered as cost-effective compared to the standard of care from a Swedish healthcare and public sector perspective.
    MeSH term(s) Anticoagulants/therapeutic use ; Atrial Appendage/surgery ; Atrial Fibrillation/drug therapy ; Contraindications ; Cost-Benefit Analysis ; Humans ; Stroke/complications ; Stroke/prevention & control ; Treatment Outcome
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-12-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehab847
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Employment transitions for spouses of stroke survivors

    Josefine Persson / Gunnel Hensing / Carl Bonander

    BMC Public Health, Vol 20, Iss 1, Pp 1-

    evidence from Swedish national registries

    2020  Volume 9

    Abstract: Abstract Background The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke ... ...

    Abstract Abstract Background The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses’ employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect. Method Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1818 spouses of first ever stroke survivors during 2010 and 2011, and 7399 matched controls that were employed or unemployed during 5 years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset. Results Employed spouses prior stroke onset reduced their employment by − 1.3 percentage points (95% CI, − 2.4, − 0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset. Conclusion The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.
    Keywords Stroke ; Spouse ; Employment transitions ; Labor force ; Public aspects of medicine ; RA1-1270
    Subject code 331
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article: Tape-disc-loop-mediated isothermal amplification (TD-LAMP) method as noninvasive approach for diagnosis of cutaneous leishmaniasis caused by

    Taslimi, Yasaman / Habibzadeh, Sima / Goyonlo, Vahid Mashayekhi / Akbarzadeh, Amin / Azarpour, Zahra / Gharibzadeh, Safoora / Shokouhy, Mehrdad / Persson, Josefine / Harandi, Ali M / Mizbani, Amir / Rafati, Sima

    Heliyon

    2023  Volume 9, Issue 11, Page(s) e21397

    Abstract: Cutaneous leishmaniasis (CL) is a parasitic disease caused by the bite of infectious female sand flies with high socioeconomic burdens. There is currently no non-invasive, point-of-care, diagnostic method with high sensitivity and specificity available ... ...

    Abstract Cutaneous leishmaniasis (CL) is a parasitic disease caused by the bite of infectious female sand flies with high socioeconomic burdens. There is currently no non-invasive, point-of-care, diagnostic method with high sensitivity and specificity available for CL. We herein report the development of a non-invasive tape disc (TD) sampling method combined with a loop-mediated isothermal amplification (LAMP) assay using primer sets targeting kinetoplast DNA (kDNA) of
    Language English
    Publishing date 2023-10-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2023.e21397
    Database MEDical Literature Analysis and Retrieval System OnLINE

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