Comparison of commercially available, rapid, point-of-care C-reactive protein assays among children with febrile illness in southwestern Uganda.
Comparison of commercially available, rapid, point-of-care C-reactive protein assays among children with febrile illness in southwestern Uganda.
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DOI：
10.1371/journal.pgph.0002727
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发表时间：
2024
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在乌干达，患有发热性疾病的儿童经常接受抗生素治疗，尽管大多数儿童患有自限性感染（可能是病毒感染）。 C 反应蛋白 (CRP) 测量可以帮助识别那些更有可能受到细菌感染并因此需要抗生素治疗的人。在资源有限、实验室基础设施最少的情况下，在护理点实施 CRP 快速诊断检测 (RDT) 可以减少不必要的抗生素使用。在本研究中，我们根据需要电动分析仪 (Afinion) 的参考 CRP 检测评估了三种半定量 CRP RDT（Actim、BTNX、Duo）的性能。虽然两项测试都表明与 Afinion 基本一致，但 Actim 的一致性略高于 BTNX。 BTNX 测试的灵敏度较高，而 Actim 测试的特异性较高，截止值分别为 40 mg/L 和 80 mg/L。在 20 mg/L 的截止浓度下，Duo 也表现出与 Afinion 测试基本一致。我们的结果证明了 CRP RDT 与参考标准相比的可靠性。无需实验室分析仪的 CRP RDT 是在资源匮乏的环境中优化抗生素使用的有前途的工具。
In Uganda, children with febrile illness are often treated with antibiotics even though most have self-limiting, likely viral, infections. C-reactive protein (CRP) measurement can help identify those who are more likely to have a bacterial infection and therefore need antibiotic treatment. Implementation of a CRP rapid diagnostic test (RDT) at the point-of-care in resource-constrained settings with minimal laboratory infrastructure could reduce unnecessary antibiotic use. In this study, we evaluated the performance of three semi-quantitative CRP RDTs (Actim, BTNX, Duo) against a reference CRP assay requiring an electrically powered analyzer (Afinion). While both tests demonstrated substantial agreement with Afinion, Actim had slightly higher agreement than BTNX. The sensitivity was higher for the BTNX test, whereas the Actim test had a higher specificity, at cut-offs of 40 mg/L and 80 mg/L. At a cut-off of 20 mg/L, Duo demonstrated substantial agreement with the Afinion test as well. Our results demonstrate the reliability of CRP RDTs when compared to a reference standard. CRP RDTs without the need for a laboratory-based analyzer are promising tools for optimizing antibiotic use in low-resource settings.