Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
复制标题
评估PFHRP2和基于PLDH的快速诊断测试，以诊断2名非洲儿童种群的严重疟疾诊断。
DOI：
10.1093/cid/cir143
复制
发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
Dondorp AM
中科院分区：
文献类型：
--
作者：
Hendriksen IC;Mtove G;Pedro AJ;Gomes E;Silamut K;Lee SJ;Mwambuli A;Gesase S;Reyburn H;Day NP;White NJ;von Seidlein L;Dondorp AM
这项对2个不同非洲人群的1898名儿童进行的比较研究表明，基于pfHRP2的快速诊断测试是在这些环境中诊断严重恶性疟疾的可靠诊断方法，并且比常规显微镜或基于pLDH的测试表现更好。背景：在恶性疟疾流行的许多国家， 快速诊断试验(RDT)现在在恶性疟疾的诊断中发挥着重要作用。尽管这些检测方法已经在非复杂恶性疟疾中进行了广泛评估，但缺乏可靠的数据，说明它们在诊断潜在致命的严重疟疾方面的表现。方法： 我们比较了莫桑比克和坦桑尼亚两个中心1898名患有严重发热性疾病的儿童中，基于恶性疟原虫富含组氨酸蛋白2(PfHRP2)的RDT和基于疟原虫乳酸脱氢酶(PLDH)的RDT与外周血片常规显微镜和专家显微镜作为诊断严重疟疾的参考标准。结果： 基于PfHRP2的试验的总体灵敏度、特异度、阳性预测值和阴性预测值分别为94.0%、70.9%、85.4%和86.8%，基于PLDH的试验的灵敏度、特异度、阳性预测值和阴性预测值分别为88.0%、88.3%、93.2%和80.3%。在寄生虫计数为1000个寄生虫/μ的L(n=173)时，基于pLDH的检测的敏感性(45.7%)低于基于PfHRP2的检测(69.9%)。根据其中一个中心的评估，两个RDT的表现都好于临床实验室中常规的载玻片读数。结论： 评估的基于PfHRP2的RDT是一种可以接受的替代常规显微镜诊断非洲儿童严重疟疾的方法，并且比评估的基于PLDH的RDT表现更好。
This comparative study in 1898 children in 2 different African population shows that a pfHRP2-based rapid diagnostic test is a reliable diagnostic for diagnosing severe falciparum malaria in these settings and performs better than routine microscopy or a pLDH based test. Background. Rapid diagnostic tests (RDTs) now play an important role in the diagnosis of falciparum malaria in many countries where the disease is endemic. Although these tests have been extensively evaluated in uncomplicated falciparum malaria, reliable data on their performance for diagnosing potentially lethal severe malaria is lacking. Methods. We compared a Plasmodium falciparum histidine-rich-protein2 (PfHRP2)–based RDT and a Plasmodium lactate dehydrogenase (pLDH)–based RDT with routine microscopy of a peripheral blood slide and expert microscopy as a reference standard for the diagnosis of severe malaria in 1898 children who presented with severe febrile illness at 2 centers in Mozambique and Tanzania. Results. The overall sensitivity, specificity, positive predictive value, and negative predictive values of the PfHRP2-based test were 94.0%, 70.9%, 85.4%, and 86.8%, respectively, and for the pLDH-based test, the values were 88.0%, 88.3%, 93.2%, and 80.3%, respectively. At parasite counts <1000 parasites/μL (n = 173), sensitivity of the pLDH-based test was low (45.7%), compared with that of the PfHRP2-based test (69.9%). Both RDTs performed better than did the routine slide reading in a clinical laboratory as assessed in 1 of the centers. Conclusion. The evaluated PfHRP2-based RDT is an acceptable alternative to routine microscopy for diagnosing severe malaria in African children and performed better than did the evaluated pLDH-based RDT.
登录
查看更多内容
影响因子：
3
作者：
Kyabayinze DJ;Tibenderana JK;Odong GW;Rwakimari JB;Counihan H
通讯作者：
Counihan H
影响因子：
3.3
作者：
Gwer, Samson;Newton, Charles R. J. C.;Berkley, James A.
通讯作者：
Berkley, James A.
影响因子：
3.3
作者：
Molyneux, E;Walsh, A;Molyneux, M
通讯作者：
Molyneux, M
影响因子：
168.9
作者：
Dondorp, Arjen M.;Fanello, Caterina I.;White, Nicholas J.
通讯作者：
White, Nicholas J.
影响因子：
168.9
作者：
Alonso, PL;Sacarlal, J;Ballou, WR
通讯作者：
Ballou, WR