Diagnosing Severe Falciparum Malaria in Parasitaemic African Children: A Prospective Evaluation of Plasma PfHRP2 Measurement
Diagnosing Severe Falciparum Malaria in Parasitaemic African Children: A Prospective Evaluation of Plasma PfHRP2 Measurement
复制标题
DOI：
10.1371/journal.pmed.1001297
复制
发表时间：
2012-08-01
期刊：
影响因子：
15.8
通讯作者：
Dondorp, Arjen M.
中科院分区：
文献类型：
--
作者：
Hendriksen, Ilse C. E.;Mwanga-Amumpaire, Juliet;Dondorp, Arjen M.
背景：在非洲儿童中，将严重恶性疟疾与其他伴有恶性疟原虫寄生血症的严重发热性疾病区分开来是一项重大挑战。恶性疟原虫富组氨酸蛋白2 （PfHRP2）由成熟的隔离寄生虫释放，可用于估计寄生虫的总负荷。我们研究了血浆PfHRP2的预后意义，并用它来估计诊断为严重疟疾的非洲儿童的疟疾归因比例。方法和发现：在一项比较静脉注射青蒿琥酯和奎宁的临床试验（AQUAMAT试验，ISRCTN 50258054）中，前瞻性地测量了1个月至15岁的非洲儿童（来自莫桑比克、冈比亚、肯尼亚、坦桑尼亚、乌干达、卢旺达和刚果民主共和国）入院血浆PfHRP2水平，这些儿童患有严重发热性疾病，并且基于恶性疟原虫乳酸脱氢酶（pLDH）的快速检测呈阳性。在3826例重症患儿中，昏迷（p = 0.0209）和酸中毒（p = 0.05）患儿中恶性疟原虫PfHRP2含量较高
Background: In African children, distinguishing severe falciparum malaria from other severe febrile illnesses with coincidental Plasmodium falciparum parasitaemia is a major challenge. P. falciparum histidine-rich protein 2 (PfHRP2) is released by mature sequestered parasites and can be used to estimate the total parasite burden. We investigated the prognostic significance of plasma PfHRP2 and used it to estimate the malaria-attributable fraction in African children diagnosed with severe malaria.Methods and Findings: Admission plasma PfHRP2 was measured prospectively in African children (from Mozambique, The Gambia, Kenya, Tanzania, Uganda, Rwanda, and the Democratic Republic of the Congo) aged 1 month to 15 years with severe febrile illness and a positive P. falciparum lactate dehydrogenase (pLDH)-based rapid test in a clinical trial comparing parenteral artesunate versus quinine (the AQUAMAT trial, ISRCTN 50258054). In 3,826 severely ill children, Plasmadium falciparum PfHRP2 was higher in patients with coma (p = 0.0209), acidosis (p