Malaria parasitaemia and mRDT diagnostic performances among symptomatic individuals in selected health care facilities across Ghana.
Malaria parasitaemia and mRDT diagnostic performances among symptomatic individuals in selected health care facilities across Ghana.
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DOI：
10.1186/s12889-021-10290-1
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发表时间：
2021-01-28
影响因子：
4.5
通讯作者：
Malm KL
中科院分区：
文献类型：
--
作者：
Abuaku B;Amoah LE;Peprah NY;Asamoah A;Amoako EO;Donu D;Adu GA;Malm KL
寄生虫学诊断生成的数据可帮助疟疾流行国家确定其在消除疟疾连续过程中的地位，并为部署经过验证的干预措施提供信息，以产生最大影响。本研究确定了加纳各地选定的医疗机构中发热患者的疟原虫血症患病率和 mRDT 表现。这项研究是 2018 年 5 月至 8 月在加纳之前 10 个地区进行的一项横断面调查。对每名疑似患有单纯性疟疾的患者进行了显微镜检查和两种疟疾快速诊断测试 (mRDT)：常规使用的 CareStart™ Malaria HRP2 (Pf) 和 SD Bioline Malaria Ag Pf (HRP2/pLDH)。主要结果变量是疟疾幻灯片和 CareStart™ 疟疾 HRP2 (Pf) 阳性率；使用显微镜作为“金标准”的 CareStart™ Malaria HRP2 (Pf) 和 SD Bioline Malaria Ag Pf (HRP2/pLDH) 的诊断准确性。 mRDT 的总体寄生虫阳性率为 32.3% (6266/19402)，显微镜检查的寄生虫阳性率为 16.0% (2984/18616)，其中恶性疟原虫单一感染占所有感染的 98.0%。与男性相比，女性患者镜检发现寄生虫血症的几率显着较低（OR = 0.78；95% CI：0.66-0.91），而有既往抗疟药物服用史的患者与无此病史的患者相比（OR = 0.72；95% CI：0.54-0.95）。 CareStart™ Malaria HRP2 (Pf) 的总体敏感性在统计上与 SD Bioline Malaria Ag Pf (HRP2/pLDH) 组合试剂盒的 HRP2 条带相似（95.4%；95% CI：94.6–96.1 vs 94.3%；95% CI：93.4–95.1；p = 0.065），但显着高于 pLDH 条带（89.3%；95% CI：88.1–90.4；p < 0.001）。阴性预测值也观察到相同的模式。疟疾控制干预措施应针对普通人群，抗疟药摄入史被认为是疟疾阴性的关键预测因素。此外，基于 HRP2 的 mRDT 仍然是该国疑似单纯性疟疾管理的有效诊断工具。在线版本包含可在 10.1186/s12889-021-10290-1 获取的补充材料。
Parasitological diagnosis generates data to assist malaria-endemic countries determine their status within the malaria elimination continuum and also inform the deployment of proven interventions to yield maximum impact. This study determined prevalence of malaria parasitaemia and mRDT performances among febrile patients in selected health care facilities across Ghana. This study was a cross-sectional survey conducted in the previously 10 regions of Ghana from May to August 2018. Each patient suspected to have uncomplicated malaria was tested using microscopy and two malaria rapid diagnostic tests (mRDTs): routinely used CareStart™ Malaria HRP2 (Pf) and SD Bioline Malaria Ag Pf (HRP2/pLDH). Main outcome variables were malaria slide and CareStart™ Malaria HRP2 (Pf) positivity rates; and diagnostic accuracy of CareStart™ Malaria HRP2 (Pf) and SD Bioline Malaria Ag Pf (HRP2/pLDH) using microscopy as “gold standard”. Overall parasite positivity rates were 32.3% (6266/19402) by mRDT and 16.0% (2984/18616) by microscopy, with Plasmodium falciparum mono-infection accounting for 98.0% of all infections. The odds of parasitaemia by microscopy was significantly lower among female patients compared with males (OR = 0.78; 95% CI: 0.66–0.91), and among patients with history of previous antimalarial intake compared with those with no such history (OR = 0.72; 95% CI: 0.54–0.95). Overall sensitivity of CareStart™ Malaria HRP2 (Pf) was statistically similar to that of the HRP2 band of SD Bioline Malaria Ag Pf (HRP2/pLDH) combo kit (95.4%; 95% CI: 94.6–96.1 vs 94.3%; 95% CI: 93.4–95.1; p = 0.065) but significantly higher than the pLDH band (89.3%; 95% CI: 88.1–90.4; p < 0.001). The same pattern was observed for negative predictive value. Malaria control interventions should be targeted at the general population, and history of antimalarial intake considered a key predictor of malaria slide negativity. Furthermore, HRP2-based mRDTs remain effective diagnostic tool in the management of suspected uncomplicated malaria in the country. The online version contains supplementary material available at 10.1186/s12889-021-10290-1.
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3
作者：
Adigun AB;Gajere EN;Oresanya O;Vounatsou P
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