Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
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DOI：
10.1371/journal.pone.0033014
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Emerson PM
中科院分区：
文献类型：
--
作者：
Endeshaw T;Graves PM;Ayele B;Mosher AW;Gebre T;Ayalew F;Genet A;Mesfin A;Shargie EB;Tadesse Z;Teferi T;Melak B;Richards FO;Emerson PM
建议在治疗前对疟疾疑似病例进行诊断测试，但与独立专家显微镜相比，农村卫生中心的显微镜和快速诊断测试(RDT)的性能比较研究很少。2007年10月至12月期间，从埃塞俄比亚西北部阿姆哈拉地区州的10个传播强度范围不同的卫生中心招募了疑似疟疾患者(N = 1997年)。卫生中心技术人员立即进行显微镜检查和ParaScreen PAN/PF®RDT检查。血液玻片后来在一个中心实验室由独立的专业显微镜专家重新检查。在1,997例发热患者中，镜检阳性475例(23.8%)，其中恶性疟原虫57.7%，间日疟原虫24.6%，混合感染17.7%。在5个卫生中心(其中4个疟疾流行率最高)，卫生中心镜检员对任何疟疾种类的敏感度为90%，在9个中心为70%，在一个疟疾流行率最低的地点为44%。健康中心显微镜的特异性在所有中心都很好(95%)。对于ParaScreen RDT，3个中心的敏感度为≥90%，6个中心的敏感度为≥70%，4个中心的敏感度为60%。除1个中心的≥为85%外，其余中心的特异性均为90%。健康中心的镜检员在十个健康中心中有九个表现良好；而对于ParaScreen RDT，他们只在六个中心表现良好。总体而言，对于所有结果，局部显微镜的准确性都超过了RDT。这项研究支持只有在各级进行适当的培训、频繁的监督和质量控制的情况下才能引入区域技术援助。在一些卫生中心使用RDT之前，必须纠正RDT使用的不足，然后才能普遍使用RDT来取代良好的常规显微镜。维护和加强高质量的显微镜仍然是卫生中心一级的优先事项。
Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy. Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists. Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P.falciparum, 24.6% P.vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%. Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.
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影响因子：
3.5
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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