How long do rapid diagnostic tests remain positive after anti-malarial treatment?
How long do rapid diagnostic tests remain positive after anti-malarial treatment?
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DOI：
10.1186/s12936-018-2371-9
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发表时间：
2018-06-08
期刊：
影响因子：
3
通讯作者：
Cameron E
中科院分区：
文献类型：
--
作者：
Dalrymple U;Arambepola R;Gething PW;Cameron E
在疟疾流行的国家，快速诊断检测正日益成为疟疾感染临床诊断和家庭疟疾指标调查中估计社区寄生虫流行率的一个范例。已知RDT检测到的抗原在抗疟药治疗后持续存在于血液中，但关于这些抗原治疗后持续时间（及其对RDT阳性的影响）的报告一直存在差异。在这篇综述中，整理了已发表的关于治疗后RDTs阳性持续性的研究，并采用定制的贝叶斯生存模型来估计治疗后RDTs保持阳性的天数。半数检测富含组氨酸的抗原蛋白II（HRP 2）的RDT在治疗后15（5-32）天仍呈阳性，比检测疟原虫乳酸脱氢酶抗原的RDT长13天，5%的HRP 2 RDT在治疗后36（21-61）天仍呈阳性。检测两种抗原的组合RDT的持续阳性持续时间福尔斯介于仅HRP 2或仅pLDH RDT之间，半数RDT在治疗后7（2-20）天保持阳性。这项研究表明，儿童在治疗后显示持续的RDT阳性时间比成人长，并且当一个人接受青蒿素联合治疗时，持续的阳性比接受其他抗疟疾药物治疗时更常见。抗疟药治疗后，RDT在一段高度可变的时间内保持阳性，阳性持续时间高度依赖于用于诊断的RDT类型。此外，年龄和治疗均影响RDT阳性持续时间。这里提出的结果表明，应谨慎使用RDT衍生的诊断结果的横截面数据，其中个人有抗疟疾治疗的最近的历史。本文的在线版本（10.1186/s12936-018-2371-9）包含补充材料，可供授权用户使用。
Rapid diagnostic tests (RDTs) are increasingly becoming a paradigm for both clinical diagnosis of malaria infections and for estimating community parasite prevalence in household malaria indicator surveys in malaria-endemic countries. The antigens detected by RDTs are known to persist in the blood after treatment with anti-malarials, but reports on the duration of persistence (and the effect this has on RDT positivity) of these antigens post-treatment have been variable. In this review, published studies on the persistence of positivity of RDTs post-treatment are collated, and a bespoke Bayesian survival model is fit to estimate the number of days RDTs remain positive after treatment. Half of RDTs that detect the antigen histidine-rich protein II (HRP2) are still positive 15 (5–32) days post-treatment, 13 days longer than RDTs that detect the antigen Plasmodium lactate dehydrogenase, and that 5% of HRP2 RDTs are still positive 36 (21–61) days after treatment. The duration of persistent positivity for combination RDTs that detect both antigens falls between that for HRP2- or pLDH-only RDTs, with half of RDTs remaining positive at 7 (2–20) days post-treatment. This study shows that children display persistent RDT positivity for longer after treatment than adults, and that persistent positivity is more common when an individual is treated with artemisinin combination therapy than when treated with other anti-malarials. RDTs remain positive for a highly variable amount of time after treatment with anti-malarials, and the duration of positivity is highly dependent on the type of RDT used for diagnosis. Additionally, age and treatment both impact the duration of persistence of RDT positivity. The results presented here suggest that caution should be taken when using RDT-derived diagnostic outcomes from cross-sectional data where individuals have had a recent history of anti-malarial treatment. The online version of this article (10.1186/s12936-018-2371-9) contains supplementary material, which is available to authorized users.
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影响因子：
3
作者：
Maltha J;Guiraud I;Lompo P;Kaboré B;Gillet P;Van Geet C;Tinto H;Jacobs J
通讯作者：
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影响因子：
3
作者：
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通讯作者：
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DOI：
10.1016/j.trstmh.2007.09.014
发表时间：
2008-01-01
影响因子：
2.2
作者：
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通讯作者：
Guthmann, Jean-Paul
影响因子：
2.1
作者：
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影响因子：
2.2
作者：
Kocharekar MM;Sarkar SS;Dasgupta D
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