Comparison of Giemsa microscopy with nested PCR for the diagnosis of malaria in North Gondar, north-west Ethiopia.
Comparison of Giemsa microscopy with nested PCR for the diagnosis of malaria in North Gondar, north-west Ethiopia.
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DOI：
10.1186/1475-2875-13-174
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发表时间：
2014-05-07
期刊：
影响因子：
3
通讯作者：
Noedl H
中科院分区：
文献类型：
--
作者：
Alemu A;Fuehrer HP;Getnet G;Kassu A;Getie S;Noedl H
疟疾仍然是埃塞俄比亚的主要传染病之一。早期诊断与及时治疗相结合是疟疾预防和控制的主要战略之一。尽管有其局限性，姬姆萨显微镜仍然被认为是疟疾诊断的金标准。本研究旨在比较姬姆萨显微镜与巢式聚合酶链反应（nPCR）在埃塞俄比亚西北部疟疾诊断中的性能。2013年3月至2013年4月，在北贡达尔的公共卫生设施进行了一项横断面研究。共有297例疑似疟疾受试者入组本研究。采集手指采血样本，并使用Giemsa显微镜和标准nPCR检查疟原虫寄生虫。在研究参与者中，61.6%（183/297）的患者经Giemsa显微镜检测为疟疾阳性，其中72.1%（132/183）被诊断为恶性疟原虫和27.9%（51/183）被诊断为间日疟原虫。经nPCR检测，73.1%（217/297）为疟疾阳性。在显微镜阴性样本中，13.1%（39/297）的样本在nPCR中转为疟疾阳性。混合感染率为4.7%（14/297），卵型疟原虫阳性率为3.03%（9/297）。以nPCR为参照，Giemsa镜检法的敏感性、特异性、阳性预测值和阴性预测值分别为82.0%、93.8%、97.3%和65.8%，与巢式PCR法的一致性较好（κ = 0.668）。姬姆萨镜检诊断恶性疟原虫感染的敏感性和特异性分别为74.0%和87.4%;诊断间日疟原虫感染的敏感性和特异性分别为63.2%和96.5%。虽然姬姆萨显微镜仍然是在资源有限的环境中诊断疟疾的金标准，但与nPCR相比，其灵敏度和特异性有限，这表明为疟疾流行国家探索新的快速和简化的分子技术。分类错误和识别错误的比率很高，这突出表明对参与疟疾诊断的工作人员进行适当培训的重要性。
Malaria remains one of the leading communicable diseases in Ethiopia. Early diagnosis combined with prompt treatment is one of the main strategies for malaria prevention and control. Despite its limitation, Giemsa microscopy is still considered to be the gold standard for malaria diagnosis. This study aimed to compare the performance of Giemsa microscopy with nested polymerase chain reaction (nPCR) for the diagnosis of malaria in north-west Ethiopia. A cross sectional study was conducted in public health facilities in North Gondar, from March 2013 to April 2013. A total number of 297 subjects with suspected malaria were enrolled in the study. Finger-prick blood samples were collected and examined for Plasmodium parasites using Giemsa microscopy and standard nPCR. Among the study participants, 61.6% (183/297) patients tested positive for malaria by Giemsa microscopy of which, 72.1% (132/183) and 27.9% (51/183) were diagnosed as Plasmodium falciparum and Plasmodium vivax, respectively. By nPCR, 73.1% (217/297) were malaria-positive. Among microscopy-negative samples, 13.1% (39/297) samples turned malaria-positive in nPCR. In nPCR, the rate of mixed Plasmodium infections was 4.7% (14/297) and 3.03% (9/297) were positive for Plasmodium ovale. Using nPCR as reference the sensitivity, specificity, positive predictive and negative predictive values of Giemsa microscopy were 82.0%, 93.8%, 97.3% and 65.8%, respectively, with a good agreement (κ = 0.668) to nested PCR. The sensitivity and specificity of Giemsa microscopy in identifying P. falciparium infections were 74.0% and 87.4% and 63.2% and 96.5% for P. vivax infections, respectively. Although Giemsa microscopy remains the gold standard for malaria diagnosis in resource-limited environments, its sensitivity and specificity as compared to nPCR is limited suggesting exploration of novel rapid and simplified molecular techniques for malaria-endemic countries. A high rate of misclassification and misidentification highlights the importance of adequate training for staff involved in malaria diagnosis.
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影响因子：
9.4
作者：
Fuehrer, Hans-Peter;Stadler, Marie-Therese;Noedl, Harald
通讯作者：
Noedl, Harald
影响因子：
3
作者：
Alemu, Abebe;Fuehrer, Hans-Peter;Noedl, Harald
通讯作者：
Noedl, Harald
影响因子：
3.2
作者：
Alemu, Abebe;Muluye, Dagnachew;Gebeyaw, Melkamu
通讯作者：
Gebeyaw, Melkamu
影响因子：
3.7
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
通讯作者：
Emerson PM
影响因子：
3.2
作者：
Alemu, Abebe;Abebe, Gemeda;Golassa, Lemu
通讯作者：
Golassa, Lemu