Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: Implications for monitoring and evaluation
Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: Implications for monitoring and evaluation
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DOI：
10.1016/j.actatropica.2009.08.011
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发表时间：
2009-12-01
期刊：
影响因子：
2.7
通讯作者：
Eisele, Thomas P.
中科院分区：
文献类型：
--
作者：
Keating, Joseph;Miller, John M.;Eisele, Thomas P.
本文介绍了赞比亚卢安瓜区（卢萨卡省）基于人口的家庭调查对 5 岁以下儿童恶性疟原虫感染流行率的估计，该地区超过 75% 的家庭拥有至少一个经杀虫剂处理的蚊帐 (ITN)。还介绍了 HRP-2 快速诊断测试 (RDT) (ICT Malaria Pf (R)) 与显微镜检查相比的敏感性和特异性，以及与诊断结果不一致相关的因素。使用显微镜检查估计恶性疟原虫感染率为 7.0% (95% CI 4.9-9.0%)。以显微镜检查为金标准，HRP-2 RDT的敏感性为100%，特异性为91.5%；阳性预测值估计为 46.7% (95% CI 36.3-57.4%)。 RDT 不一致（或 HRP-2 假阳性）在年龄较大的儿童、卢安瓜区北部的儿童以及有抗疟治疗史的儿童中最高。这些数据表明，显微镜检查仍应是用于监测和评估目的的家庭调查估计疟原虫点流行率的黄金标准。 (c) 2009 Elsevier B.V. 保留所有权利。
This paper presents estimates of A falciparum infection prevalence in children under 5 years old in the context of a population-based household survey in Luangwa District (Lusaka Province), Zambia, an area where greater than 75% of households possess at least one insecticide-treated mosquito net(ITN). The sensitivity and specificity of an HRP-2 rapid diagnostic test (RDT) (ICT Malaria Pf (R)) compared to microscopy, as well as factors associated with discordant diagnostic results are also presented. P. falciparum infection prevalence was estimated at 7.0% (95% CI 4.9-9.0%) using microscopy. Using microscopy as the gold standard, the sensitivity of the HRP-2 RDT was 100% and specificity was 91.5%; positive predictive value was estimated to be 46.7% (95% CI 36.3-57.4%). RDT discordance, or HRP-2 false positivity, was highest among older children, those in the northern part of Luangwa District, and those with a reported history of antimalarial treatment. These data suggest microscopy should remain the gold standard for estimating malaria parasite point prevalence from household surveys for monitoring and evaluation purposes. (c) 2009 Elsevier B.V. All rights reserved.