State of malaria diagnostic testing at clinical laboratories in the United States, 2010: a nationwide survey.
State of malaria diagnostic testing at clinical laboratories in the United States, 2010: a nationwide survey.
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DOI：
10.1186/1475-2875-10-340
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发表时间：
2011-11-10
期刊：
影响因子：
3
通讯作者：
Gutman J
中科院分区：
文献类型：
--
作者：
Abanyie FA;Arguin PM;Gutman J
在美国等非疟疾流行地区，疟疾的诊断可能很困难，诊断延误和治疗错误经常发生。2010年对美国及其9个附属领土的实验室进行了一次全国性调查，以确定可能导致疟疾诊断不足的因素。这项调查探讨了疟疾诊断检测的可用性、使用的技术和报告做法。该调查由201名参与者完成。90%的人报告说，他们的实验室至少有一种现场可用的疟疾诊断测试。几乎所有受访者的实验室都在现场进行厚涂片和薄涂片;大约50%的实验室可以进行分子检测;只有17%的实验室可以进行现场快速诊断检测。在调查前的12个月期间，73%的人报告在他们的实验室中确诊的疟疾病例少于5例。28%的人表示，物种鉴定结果需要24小时以上才能报告。在149名每周7天、每天24小时进行检测的受访者中，只有5名符合临床和实验室标准化协会（CLSI）关于分析和报告结果的所有指南。虽然接受调查的大多数美国实验室都提供疟疾诊断检测服务，但很少有实验室完全遵守CLSI的所有结果分析和报告指南，大多数受访者每年报告的疟疾病例很少。实验室难以遵守严格的CLSI指南，其工作人员缺乏实践和熟练程度，可能导致诊断延迟和错误。建议不经常处理疟疾样本的实验室每年寻找机会进行实践和熟练程度培训，并利用现有资源协助物种鉴定。
The diagnosis of malaria can be difficult in non-endemic areas, such as the United States, and delays in diagnosis and errors in treatment occur too often. A nationwide survey of laboratories in the United States and its nine dependent territories was conducted in 2010 to determine factors that may contribute to shortcomings in the diagnosis of malaria. This survey explored the availability of malaria diagnostic tests, techniques used, and reporting practices. The survey was completed by 201 participants. Ninety percent reported that their laboratories had at least one type of malaria diagnostic test available on-site. Nearly all of the respondents' laboratories performed thick and thin smears on-site; approximately 50% had access to molecular testing; and only 17% had access to rapid diagnostic tests on-site. Seventy-three percent reported fewer than five confirmed cases of malaria in their laboratory during the 12-month period preceding the survey. Twenty-eight percent stated that results of species identification took more than 24 hours to report. Only five of 149 respondents that performed testing 24 hours a day, 7 days a week complied with all of the Clinical and Laboratory Standards Institute (CLSI) guidelines for analysis and reporting of results. Although malaria diagnostic testing services were available to a majority of U.S. laboratories surveyed, very few were in complete compliance with all of the CLSI guidelines for analysis and reporting of results, and most respondents reported very few cases of malaria annually. Laboratories' difficulty in adhering to the rigorous CLSI guidelines and their personnel's lack of practice and proficiency may account for delays and errors in diagnosis. It is recommended that laboratories that infrequently process samples for malaria seek opportunities for practice and proficiency training annually and take advantage of available resources to assist in species identification.
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3
作者：
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