Accuracy of PfHRP2 versus Pf-pLDH antigen detection by malaria rapid diagnostic tests in hospitalized children in a seasonal hyperendemic malaria transmission area in Burkina Faso.
Accuracy of PfHRP2 versus Pf-pLDH antigen detection by malaria rapid diagnostic tests in hospitalized children in a seasonal hyperendemic malaria transmission area in Burkina Faso.
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DOI：
10.1186/1475-2875-13-20
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发表时间：
2014-01-13
期刊：
影响因子：
3
通讯作者：
Jacobs J
中科院分区：
文献类型：
--
作者：
Maltha J;Guiraud I;Lompo P;Kaboré B;Gillet P;Van Geet C;Tinto H;Jacobs J
在大多数撒哈拉以南非洲国家，疟疾快速诊断测试现在用于诊断疟疾。大多数RDT用于检测恶性疟原虫富组氨酸蛋白-2（PfHRP 2），尽管检测恶性疟原虫特异性寄生虫乳酸脱氢酶（Pf-pLDH）的RDT可能优于检测PfHRP 2的RDT。只有很少的数据是在严重疾病中使用RDTs和本研究比较Pf-pLDH PfHRP 2检测。年龄在1个月至14岁之间，因发烧或严重疾病住院的儿童被纳入一年以上。抽取静脉血样本用于疟疾诊断（显微镜检查和RDT）、培养和全血细胞计数。将剩余物储存在-80 °C下并用于额外的RDT分析和PCR。对所有样本进行靶向PfHRP 2和Pf-pLDH的RDT，以直接比较诊断准确性，并将显微镜检查作为参考方法。进行PCR以探索假阳性RDT结果。在纳入的694名儿童中，有376名（54.2%）经显微镜证实患有疟疾。PfHRP 2检测的敏感性、特异性、阳性预测值（PPV）和阴性预测值分别为100.0%、70.9%、69.4%和100.0%; Pf-pLDH检测的敏感性、特异性、阳性预测值（PPV）和阴性预测值分别为98.7%、94.0%、91.6%和99.1%。PfHRP 2检测的特异性和PPV显着较低（p <0.001）。对于这两种检测抗原，特异性最低的儿童1至5岁，在雨季。两种抗原的PPV在雨季最高，因为疟疾流行率较高。PfHRP 2假阳性结果与既往抗疟疾治疗和阳性PCR结果相关（98/114（86.0%）检测样本）。在季节性高流行性疟疾传播地区出现严重发热疾病的儿童中，本研究观察到PfHRP 2与Pf-pLDH检测相比具有相似的灵敏度，但特异性和PPV较低。进一步的研究应评估适当的Pf-pLDH检测RDT在现场设置中的诊断准确性和安全性，如果满意，应考虑用Pf-pLDH检测RDT替代PfHRP 2。
In most sub-Saharan African countries malaria rapid diagnostic tests (RDTs) are now used for the diagnosis of malaria. Most RDTs used detect Plasmodium falciparum histidine-rich protein-2 (PfHRP2), though P. falciparum-specific parasite lactate dehydrogenase (Pf-pLDH)-detecting RDTs may have advantages over PfHRP2-detecting RDTs. Only few data are available on the use of RDTs in severe illness and the present study compared Pf-pLDH to PfHRP2-detection. Hospitalized children aged one month to 14 years presenting with fever or severe illness were included over one year. Venous blood samples were drawn for malaria diagnosis (microscopy and RDT), culture and complete blood count. Leftovers were stored at −80 °C and used for additional RDT analysis and PCR. An RDT targeting both PfHRP2 and Pf-pLDH was performed on all samples for direct comparison of diagnostic accuracy with microscopy as reference method. PCR was performed to explore false-positive RDT results. In 376 of 694 (54.2%) included children, malaria was microscopically confirmed. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were 100.0, 70.9, 69.4 and 100.0%, respectively for PfHRP2-detection and 98.7, 94.0, 91.6 and 99.1%, respectively for Pf-pLDH-detection. Specificity and PPV were significantly lower for PfHRP2-detection (p <0.001). For both detection antigens, specificity was lowest for children one to five years and in the rainy season. PPV for both antigens was highest in the rainy season, because of higher malaria prevalence. False positive PfHRP2 results were associated with prior anti-malarial treatment and positive PCR results (98/114 (86.0%) samples tested). Among children presenting with severe febrile illness in a seasonal hyperendemic malaria transmission area, the present study observed similar sensitivity but lower specificity and PPV of PfHRP2 compared to Pf-pLDH-detection. Further studies should assess the diagnostic accuracy and safety of an appropriate Pf-pLDH-detecting RDT in field settings and if satisfying, replacement of PfHRP2 by Pf-pLDH-detecting RDTs should be considered.
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评估PFHRP2和基于PLDH的快速诊断测试，以诊断2名非洲儿童种群的严重疟疾诊断。
DOI：
10.1093/cid/cir143
发表时间：
2011-05
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
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通讯作者：
Dondorp AM
影响因子：
9.4
作者：
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通讯作者：
Rab, A
影响因子：
3
作者：
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通讯作者：
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DOI：
10.1016/j.trstmh.2007.09.014
发表时间：
2008-01-01
影响因子：
2.2
作者：
Fogg, Carole;Twesigye, Rogers;Guthmann, Jean-Paul
通讯作者：
Guthmann, Jean-Paul
影响因子：
3
作者：
Cnops L;Van Esbroeck M;Bottieau E;Jacobs J
通讯作者：
Jacobs J