A systematic review of sub-microscopic Plasmodium vivax infection.
A systematic review of sub-microscopic Plasmodium vivax infection.
复制标题
亚显微间日疟原虫感染的系统评价。
DOI：
10.1186/s12936-015-0884-z
复制
发表时间：
2015-09-22
期刊：
影响因子：
3
通讯作者：
Drakeley CJ
中科院分区：
文献类型：
--
作者：
Moreira CM;Abo-Shehada M;Price RN;Drakeley CJ
准确估计间日疟原虫流行率对于成功实施疟疾控制和消除方案至关重要。流行率估计值为控制策略提供信息，并用于评估。光学显微镜是检测外周血中疟原虫寄生虫病的主要方法，但与聚合酶链反应（PCR）等分子诊断相比，灵敏度有限。进行了系统回顾和荟萃分析，以评估检测方法对间日疟原虫患病率的影响，并量化显微镜未检出间日疟原虫感染的程度。检索Embase、Medline和科克伦数据库中报告PCR和显微镜检查患病率的研究，并包含以下所有关键词：间日疟、PCR和疟疾。从每篇出版物中系统地提取患病率估计值和研究元数据。联合显微镜检查：PCR患病率通过随机效应荟萃分析进行估计。以PCR为金标准，计算显微镜检查的灵敏度和特异性。在回顾的874项研究中，40项符合纳入标准，提供了54个患病率对。通过PCR测量的间日疟原虫感染的患病率始终高于通过显微镜测量的亚专利寄生虫血症的患病率。通过显微镜检测到的平均感染率为67%（95%CI 59- 73%），低于通过PCR检测到的感染率。亚专利寄生虫血症的检测没有根据显微镜方法（厚或厚和薄涂片），PCR流行率（作为真正的P.间日疟原虫流行率的衡量标准），使用的血液类型或DNA提取方法而变化。通过PCR而不是显微镜定量间日疟原虫寄生虫血症始终使患病率估计值增加2.3倍。虽然可以通过更好的方法提高显微镜的灵敏度，但分子方法有可能扩大规模，以提高间日疟原虫传播宿主的检测。本文的在线版本（doi：10.1186/s12936-015-0884-z）包含补充材料，可供授权用户使用。
An accurate estimate of Plasmodiumvivax prevalence is essential for the successful implementation of malaria control and elimination programmes. Prevalence estimates both inform control strategies and are used in their evaluation. Light microscopy is the main method for detecting Plasmodium parasitaemia in the peripheral blood, but compared to molecular diagnostics, such as polymerase chain reaction (PCR), has limited sensitivity. A systematic review and meta-analysis was conducted to assess the effect of detection method on the prevalence of P.vivax and to quantify the extent to which P. vivax infections are undetected by microscopy. Embase, Medline and the Cochrane Database were searched for studies reporting prevalence by PCR and by microscopy and that contained all of the following key words: vivax, PCR, and malaria. Prevalence estimates and study meta-data were extracted systematically from each publication. Combined microscopy:PCR prevalence ratios were estimated by random effects meta-analysis. Sensitivity and specificity of microscopy were calculated using PCR as the gold standard. Of 874 studies reviewed, 40 met the criteria for inclusion contributing 54 prevalence pairs. The prevalence of P.vivax infection measured by PCR was consistently higher than the prevalence measured by microscopy with sub-patent parasitaemia. The mean prevalence of infection detected by microscopy was 67 % (95 % CI 59–73 %) lower than the prevalence detected by PCR. The detection of sub-patent parasitaemia did not vary according to the microscopy method (thick or, thick and thin smears), the PCR prevalence (as a measure of the true P.vivax prevalence), the type of blood used or DNA extraction method. Quantifying P. vivax parasitaemia by PCR rather than microscopy consistently increased prevalence estimates by a factor of 2.3. Whilst the sensitivity of microscopy can be improved by better methods, molecular methods have potential to be scaled up to improve the detection of P. vivax transmission reservoirs. The online version of this article (doi:10.1186/s12936-015-0884-z) contains supplementary material, which is available to authorized users.