Microscopy underestimates the frequency of Plasmodium falciparum infection in symptomatic individuals in a low transmission highland area
Microscopy underestimates the frequency of Plasmodium falciparum infection in symptomatic individuals in a low transmission highland area
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DOI：
10.4269/ajtmh.2008.79.173
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发表时间：
2008-08-01
影响因子：
3.3
通讯作者：
John, Chandy C.
中科院分区：
文献类型：
--
作者：
Menge, David M.;Ernst, Kacey C.;John, Chandy C.
在一个地区与不稳定的疟疾传播，检测恶性疟原虫感染379个有症状的个人进行了评估，显微镜和三个聚合酶链反应（PCR）方法。通过显微镜、巢式PCR、裂殖子表面蛋白-2（MSP-2）PCR和连接酶检测反应-荧光微球试验（LDR-FMA）分别在25%、37%、41%和45%的患者中检测到恶性疟原虫感染。在LDR-FMA阳性、显微镜检查阴性且未接受治疗的64名患者中，8名（12.5%）出现持续症状并返回接受治疗。有症状个体的疟疾归因分数（MAF）通过显微镜检查为14.6%（95%置信区间[CI] = 6.6-21.8%），通过巢式PCR为28.2%（95% CI = 17.9-37.2%）。在这一高原地区，PCR比显微镜更常检测到有症状个体的恶性疟原虫感染，最常见的是LDR-FMA。在大多数LDR-FMA阳性、显微镜检查阴性的个体中，恶性疟原虫感染似乎无需治疗即可消退，但在这些个体的一个亚组中持续存在，需要治疗。
In an area with unstable malaria transmission, detection of Plasmodium falciparum infection in 379 symptomatic individuals was assessed by microscopy and three polymerase chain reaction (PCR) methodologies. P. falciparum infection was detected in 25% of patients by microscopy, 37% by nested PCR, 41% by merozoite surface protein-2 (MSP-2) PCR, and 45% by a ligase detection reaction-fluorescent microsphere assay (LDR-FMA). Of the 64 individuals who were LDR-FMA positive, microscopy negative and did not receive treatment, 8 (12.5%) had persistent symptoms and returned for treatment. Malaria attributable fraction (MAF) in symptomatic individuals was 14.6% by microscopy (95% confidence interval [CI] = 6.6-21.8%) and 28.2% by nested PCR (95% CI = 17.9-37.2%). In this highland area, P. falciparum infection in symptomatic individuals is detected more frequently by PCR than microscopy, and most frequently by LDR-FMA. P. falciparum infection appears to resolve without treatment in most LDR-FMA-positive, microscopy-negative individuals, but is persistent in a subset of these individuals and requires treatment.