Relative utility of dipsticks for diagnosis of malaria in mesoendemic area for Plasmodium falciparum and P-vivax in northeastern India
Relative utility of dipsticks for diagnosis of malaria in mesoendemic area for Plasmodium falciparum and P-vivax in northeastern India
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DOI：
10.1089/1530366041210774
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发表时间：
2004-06-01
影响因子：
2.1
通讯作者：
Dev, V
中科院分区：
文献类型：
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作者：
Dev, V
为了诊断疟疾，流行品牌的快速检测试剂盒（统称为“试纸条”）在印度东北部接受了现场评估，以评估其与传统显微镜结果相比的敏感性和特异性。基于恶性疟原虫特异性富含组氨酸蛋白 (Pf HRP-2) 抗原捕获测定的试纸显示出 100% 的灵敏度和高特异性 (94-100%)；因此，它们被认为是确诊疟疾感染的可靠工具。然而，同一试剂盒的高级版本添加了额外的泛疟疾单克隆抗体，发现对非恶性疟原虫感染的敏感性较低（71%）。此外，即使在由于持续性抗原血症而清除寄生虫血症之后，基于 Pf HRP-2 的试剂盒直到第 7 天仍继续显示阳性结果。基于寄生虫特异性乳酸脱氢酶 (pLDH) 的酶似乎克服了这一限制。成套工具。该试剂盒对恶性疟和非恶性疟均具有较高的敏感性（81-89%）和特异性（100%），但无法区分单一感染和混合感染。结论是，合理使用这些试剂盒将在早期发现和及时治疗方面带来健康益处，降低药物压力，并可能延缓多重耐药疟疾寄生虫菌株的出现和传播。
For diagnosis of malaria, popular brands of rapid test kits collectively termed as "dipsticks" were subject to field evaluation in northeastern India for their comparative sensitivity and specificity vis-a-vis conventional microscopic results. Dipsticks based on Plasmodium falciparum-specific histidine-rich protein (Pf HRP-2) antigen capture assay revealed 100% sensitivity and high specificity (94-100%); thus, they were concluded to be reliable tools for confirmed diagnosis of malarial infection. However, an advanced version of the same kit, having incorporated additional pan-malarial monoclonal antibody, was found to be less sensitive (71%) for non-falciparum infections. Besides, Pf HRP-2-based kits continued to show positive results up to day 7, even after clearance of parasitemia on account of persistent antigenemia. This very limitation seemed to have been overcome by parasite-specific lactate dehydrogenase (pLDH) enzyme-based. kit. This kit was observed to have high sensitivity (81-89%) and specificity (100%) for both falciparum and non-falciparum malaria, but cannot distinguish mono-infection from mixed infections. It is concluded that the rational use of these kits would accord health benefits in terms of early detection and prompt treatment, reduce drug pressure, and possibly delay the emergence and spread of multi-drug-resistant strains of malarial parasites.