Challenges in diagnosis of Plasmodium knowlesi infections.
Challenges in diagnosis of Plasmodium knowlesi infections.
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DOI：
10.4103/2229-5070.129156
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Parija, Subhash Chandra
中科院分区：
文献类型：
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作者：
Jeremiah, Ss;Janagond, Anand B;Parija, Subhash Chandra
诺氏疟原虫是最近发现的引起人类疟疾的第五种疟原虫。诺氏疟原虫感染目前是从东南亚国家报告的，发病率正在上升，有可能传播到地理上毗邻的国家。诺氏肺孢子虫感染可导致高度寄生虫血症，在更大比例的感染者中导致严重疟疾。如果及早发现并使用适当的抗菌药治疗，这些感染显示出显著的临床改善。广泛使用的镜检方法通常将诺氏疟原虫误认为致病性较低的疟疾，导致治疗不足和不良的临床结果。目前流行的快速免疫层析卡片检测在诊断诺氏疟疾方面的敏感性非常低，可能会错误地将诺氏疟原虫报告为其他疟原虫，反之亦然。目前，分子方法是诊断诺氏疟原虫感染最有效的方法，但这些测试可能会产生间日疟原虫感染的假阳性报告，并且需要昂贵的设备和训练有素的人员。在资源有限的情况下，一种有效、经济且实际可行的诺氏假单胞菌感染诊断试验仍有待开发。
Plasmodium knowlesi is the fifth species of Plasmodium recently identified to cause human malaria. Infections with P. knowlesi are currently being reported from South-East Asian countries and the incidence is on the rise with a possibility of spread to the geographically contiguous countries. P. knowlesi infections can result in a high degree of parasitemia causing severe malaria in a larger proportion of infected individuals. If detected early and treated with appropriate antimicrobials, these infections show a significant clinical improvement. The widely used microscopic methods usually misidentify P. knowlesi as the less pathogenic Plasmodium malariae leading to inadequate therapy and adverse clinical outcomes. The currently popular rapid immuno-chromatographic card tests have a very low sensitivity in diagnosing knowlesi malaria and can erroneously report P. knowlesi as other Plasmodia and vice-versa. At present molecular methods are the most efficacious in diagnosing P. knowlesi infections, but these tests can produce a false positive report in Plasmodium vivax infections and require expensive equipment and trained personnel. An ideal diagnostic test for P. knowlesi infections, which is potent, cost-effective and practically feasible in the resource limited setting is yet to be developed.