Point-of-care diagnostics have the potential to increase diagnosis and linkage to care and help reach the WHO targets to eliminate hepatitis C virus (HCV) by 2030. Here, we evaluated the diagnostic accuracy of Genedrive HCV ID assay for the qualitative detection of HCV RNA in decentralized settings in two low- and middle-income countries using fresh plasma specimens from 426 participants. The Abbott RealTime HCV assay was used as the gold standard. Genedrive HCV ID assay was conducted by different users. Users also completed questionnaires to assess the usability of Genedrive. At detection thresholds of 12 IU/mL or 30 IU/mL, 1000 IU/mL, and 2362 IU/mL, the sensitivity was 96.2% (95% CI: 92.7–98.4), 100% (98.2–100), and 100% (98.2–100), respectively; the specificity was 99.5% (95% CI: 97.4–100), 99.5% (97.5–100), and 98.7% (96.1–100), respectively. All genotypes detected using the gold-standard assay were also detected with Genedrive. Users found Genedrive easy to use. Genedrive is a simple and accurate test to confirm chronic HCV infection in decentralized, real-life, resource-limited settings. This novel diagnostic tool could contribute to closing the current gap in HCV diagnosis.

Introduction: Rickettsial diseases, caused by obligate intracellular Gram-negative bacteria of the genus Rickettsia, are a significant public health concern due to their potential for severe morbidity and mortality. This study aimed to determine the prevalence and species distribution of Rickettsia spp. in tick populations from various regions of Georgia, providing critical updates to epidemiological data and informing public health strategies. Methods: From 2020 to 2022, 699 pooled tick samples were collected from the Kakheti, Shida Kartli, Samegrelo, and Mtskheta-Mtianeti regions. The samples were homogenised, stored at -80°C, and processed using Qiagen and MagMAX™ CORE Nucleic Acid Purification Kits for DNA extraction. Quantitative PCR (qPCR) targeting the genus-specific 17-kD gene was employed to screen for Rickettsia. Positive samples underwent further analysis with species-specific qPCR assays to identify R. raoultii, R. slovaca, R. aeschlimannii, and R. monacensis. Results: Among the 699 samples, 160 tested positive for Rickettsia DNA. Two samples were excluded from species-specific analysis due to weak positivity. Detected species included R. raoultii (3.2%), R. slovaca (11.4%), R. aeschlimannii (39.2%), and R. monacensis (10.8%). Co-infection with multiple species was observed in 10.01% of positive samples, with 39 samples not containing any of the targeted species. Conclusion: The study highlights the diverse presence of rickettsial pathogens in Georgian ticks and confirms the ongoing prevalence of R. monacensis. These findings underscore the urgent need for enhanced surveillance and rapid response strategies to mitigate the public health risks associated with rickettsial diseases. Strengthening monitoring and control measures will be crucial in addressing these health threats effectively. შესავალი: რიკეტსიოზური დაავადებები, რომლებიც გამოწვეულია Rickettsia-ს გვარის ობლიგატური შიდაუჯრედული გრამ-უარყოფითი ბაქტერიებით, წარმოადგენენ მნიშვნელოვან საზოგადოებრივი ჯანმრთელობის პრობლემას, მათი პოტენციური მძიმე ავადობისა და სიკვდილიანობის გამო. კვლევის მიზანი იყო საქართველოს სხვადასხვა რეგიონიდან მოპოვებულ ტკიპებში Rickettsia spp.-ის გავრცელებისა და სახეობათა მრავალფეროვნების განსაზღვრა, რაც გააუმჯობესებს ეპიდემიოლოგიურ მონაცემებს და ხელს შეუწყობს საზოგადოებრივი ჯანმრთელობის სტრატეგიების შემუშავებას. მეთოდები: 2020 წლიდან 2022 წლამდე, 699 შერეული ტკიპების ნიმუში შეგროვდა კახეთის, შიდა ქართლის, სამეგრელოსა და მცხეთა-მთიანეთის რეგიონებიდან. ნიმუშები ჰომოგენიზებული იყო, შენახული -80°C...

Rickettsia spp. are obligate intracellular bacteria transmitted by arthropod vectors and are responsible for a range of potentially severe human infections. In Georgia, information on the geographic distribution and species diversity of Rickettsia spp. in ticks remains limited. This study investigated the prevalence and species distribution of Rickettsia spp. in ticks collected from four Georgian regions. Between May 2020 and June 2022, 4542 ticks were collected from domestic animals and the environment in Kakheti, Mtskheta-Mtianeti, Samegrelo, and Shida Kartli. Ticks were grouped into 699 pools according to species, sex, collection method, and location, then analysed using genus- and species-specific quantitative PCR assays targeting the 17 kDa antigen gene. Rickettsial DNA was detected in 158 of 699 pools, corresponding to an overall minimum infection rate (MIR) of 3.48%. The highest MIR was observed in Shida Kartli (5.13%). Six clinically relevant Rickettsia species were targeted using species-specific PCR assays; among these, Rickettsia raoultii, R. slovaca, R. aeschlimannii, and R. monacensis were detected in the examined tick samples, whereas R. massiliae and R. conorii were not detected. Mixed infections were detected in 16 pools. Dermacentor marginatus and Hyalomma marginatum were the tick species most frequently associated with Rickettsia detection, particularly in Kakheti and Shida Kartli, where species diversity was highest. These findings highlight regional variation in Rickettsia prevalence and diversity and support the need for continued tick-borne disease surveillance in Georgia.