Brown, Ashlyn

Purpose of review The frequency of natural disasters and man-made conflicts has risen significantly in the past two decades, coinciding with an increase in kidney transplant recipients globally. This review addresses the critical need for disaster preparedness to mitigate the severe impacts on this vulnerable patient cohort. Recent findings Kidney transplant recipients are highly dependent on robust healthcare infrastructures for ongoing care, including specialized medical staff, advanced diagnostics, and a consistent supply of immunosuppressive medications. Disasters disrupt these essential services, leading to increased risks of organ rejection, infections, and other medical complications. Strategies at various levels, from government to individual patients, can help maintain care continuity during such crises. Summary Effective disaster preparedness plans involving strategic medication stockpiling, emergency communication systems, and patient education are crucial to support kidney transplant recipients. By implementing these measures, healthcare systems can better protect the health and well being of transplant patients during and after disasters.

ABSTRACTCoccidioidesspp. are dimorphic fungi that are capable of infecting human and non-human mammals and can cause diverse manifestations of coccidioidomycosis or Valley fever (VF). In combination with clinical symptoms and radiographic findings, antibody-based diagnostic tests are often used to diagnose and monitor patients with VF. Chitinase 1 (CTS1) has previously been identified as the seroreactive antigen used in these diagnostic assays to detect anticoccidial IgG. Here, an indirect enzyme-linked immunosorbent assay to detect IgG to CTS1 demonstrated 165 of 178 (92.7%) patients with a positive result by immunodiffusion (ID) and/or complement fixation (CF) had antibodies to the single antigen CTS1. We then developed a rapid antibody lateral flow assay (LFA) to detect anti-CTS1 antibodies. Out of 143 samples tested, the LFA showed 92.9% positive percent agreement [95% confidence interval (CI), 84.3%–96.9%] and 97.7% negative percent agreement (95% CI, 87.9%–99.6%) with ID and CF assays. Serum or plasma from canines, macaques, and dolphins was also tested by the CTS1 LFA. Test line densities of the CTS1 LFA correlated in a linear manner with the reported CF and ID titers for human and non-human samples, respectively. This 10-min point-of-care test for the rapid detection of anti-coccidioidal antibodies could help to inform healthcare providers in real-time, potentially improving the efficiency of healthcare delivery.