Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi.
Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi.
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评估三个快速诊断测试，用于检测疟原虫的人类感染。
DOI：
10.1186/1475-2875-13-60
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发表时间：
2014-02-18
期刊：
影响因子：
3
通讯作者：
Singh B
中科院分区：
文献类型：
--
作者：
Foster D;Cox-Singh J;Mohamad DS;Krishna S;Chin PP;Singh B
诺氏疟原虫是东南亚猕猴的一种疟疾寄生虫，感染人类并可导致致命的疟疾。由于形态与三日疟原虫相似，很难通过显微镜诊断。巢式PCR检测是区分诺氏疟原虫与其他疟原虫种属的最准确方法，但在资源贫乏的环境中不具有成本效益。建议在疟疾流行的环境中进行快速诊断测试。在本研究中，评价了三种RDT从新鲜和冷冻患者血液样本中检测诺氏疟原虫的有效性。在16个月期间，在马来西亚婆罗洲沙捞越招募了40名经显微镜诊断的疟疾患者（28名诺氏疟原虫、10名间日疟原虫和2名恶性疟原虫）。使用患者血液样本通过显微镜检查确定寄生虫血症，通过PCR确认存在的疟原虫种类，并评价三种RDT：OptiMAL-IT、BinaxNOW® Malaria和Paramax-3。RDTs还使用来自41名诺氏疟疾患者的冷冻血液样本进行了评估。OptiMAL-IT是最灵敏的RDT，新鲜样本的灵敏度为71%（20/28; 95% CI = 54-88%），冷冻诺氏样本的灵敏度为73%（30/41; 95% CI = 59-87%）。然而，由于恶性疟原虫检测试剂与诺氏疟原虫的交叉反应性，其主要产生恶性疟原虫阳性结果。BinaxNOW® Malaria可正确检测诺氏疟原虫样本中的非恶性疟原虫疟疾，但灵敏度最低，仅检测到29%（8/28; 95% CI = 12-46%）的新鲜样本和24%（10/41; 95% CI = 11-37%）的冷冻样本。Paramax-3 RDT对PCR确认的诺氏疟原虫样本的间日疟原虫检测呈阳性，新鲜样本的灵敏度为40%（10/25; 95% CI = 21-59%），冷冻样本的灵敏度为32%（13/41; 95% CI = 17-46%）。所有RDT均正确鉴定了寄生虫血症高于2，000个寄生虫/μl血液的恶性疟原虫和间日疟原虫阳性对照。RDTs检测诺氏疟原虫感染的血液样本中的疟原虫，灵敏度和特异性较差。诺氏疟原虫患者可能被OptiMAL-IT误诊为恶性疟原虫，Paramax-3误诊为间日疟原虫，而BinaxNOW®疟疾更准确地诊断为非间日疟原虫/非恶性疟原虫。在诺氏疟原虫感染占主导地位的环境中，需要一种敏感和特异的RDT用于疟疾诊断。
Plasmodium knowlesi, a malaria parasite of Southeast Asian macaques, infects humans and can cause fatal malaria. It is difficult to diagnose by microscopy because of morphological similarity to Plasmodium malariae. Nested PCR assay is the most accurate method to distinguish P. knowlesi from other Plasmodium species but is not cost effective in resource-poor settings. Rapid diagnostic tests (RDTs) are recommended for settings where malaria is prevalent. In this study, the effectiveness of three RDTs in detecting P. knowlesi from fresh and frozen patient blood samples was evaluated. Forty malaria patients (28 P. knowlesi, ten P. vivax and two P. falciparum) diagnosed by microscopy were recruited in Sarawak, Malaysian Borneo during a 16-month period. Patient blood samples were used to determine parasitaemia by microscopy, confirm the Plasmodium species present by PCR and evaluate three RDTs: OptiMAL-IT, BinaxNOW® Malaria and Paramax-3. The RDTs were also evaluated using frozen blood samples from 41 knowlesi malaria patients. OptiMAL-IT was the most sensitive RDT, with a sensitivity of 71% (20/28; 95% CI = 54-88%) for fresh and 73% (30/41; 95% CI = 59-87%) for frozen knowlesi samples. However, it yielded predominantly falciparum-positive results due to cross-reactivity of the P. falciparum test reagent with P. knowlesi. BinaxNOW® Malaria correctly detected non-P. falciparum malaria in P. knowlesi samples but was the least sensitive, detecting only 29% (8/28; 95% CI = 12-46%) of fresh and 24% (10/41; 95% CI = 11-37%) of frozen samples. The Paramax-3 RDT tested positive for P. vivax with PCR-confirmed P. knowlesi samples with sensitivities of 40% (10/25; 95% CI = 21-59%) with fresh and 32% (13/41; 95% CI = 17-46%) with frozen samples. All RDTs correctly identified P. falciparum- and P. vivax-positive controls with parasitaemias above 2,000 parasites/μl blood. The RDTs detected Plasmodium in P. knowlesi-infected blood samples with poor sensitivity and specificity. Patients with P. knowlesi could be misdiagnosed as P. falciparum with OptiMAL-IT, P. vivax with Paramax-3 and more correctly as non-P. vivax/non-P. falciparum with BinaxNOW® Malaria. There is a need for a sensitive and specific RDT for malaria diagnosis in settings where P. knowlesi infections predominate.
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影响因子：
3
作者：
Cox-Singh J;Hiu J;Lucas SB;Divis PC;Zulkarnaen M;Chandran P;Wong KT;Adem P;Zaki SR;Singh B;Krishna S
通讯作者：
Krishna S
在疟疾流行环境中对疟疾寄生虫血症的高度敏感性检测：在乌干达偏远诊所中新的环路介导的等温扩增试剂盒的性能。
DOI：
10.1093/infdis/jit184
发表时间：
2013-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Hopkins H;González IJ;Polley SD;Angutoko P;Ategeka J;Asiimwe C;Agaba B;Kyabayinze DJ;Sutherland CJ;Perkins MD;Bell D
通讯作者：
Bell D
影响因子：
3
作者：
Bronner, Ulf;Divis, Paul C. S.;Singh, Balbir
通讯作者：
Singh, Balbir
影响因子：
3
作者：
Rajahram GS;Barber BE;William T;Menon J;Anstey NM;Yeo TW
通讯作者：
Yeo TW
影响因子：
4
作者：
Cox-Singh, J;Mahayet, S;Singh, B
通讯作者：
Singh, B