Evaluation of two tests based on the detection of histidine rich protein 2 for the diagnosis of imported Plasmodium falciparum malaria
Evaluation of two tests based on the detection of histidine rich protein 2 for the diagnosis of imported Plasmodium falciparum malaria
复制标题
DOI：
10.1016/s0035-9203(98)91013-6
复制
发表时间：
1998-05-01
影响因子：
2.2
通讯作者：
Lynen, L
中科院分区：
文献类型：
--
作者：
Van den Ende, J;Vervoort, T;Lynen, L
ParaSight（TM）-F试纸测试（Becton Dickinson，USA）和ICT Malaria Pf（TM）测试（ICT，Australia）均检测富含组氨酸的蛋白2（HRP-2），这是由恶性疟原虫滋养体表达的水溶性抗原。本研究比较了从疟疾流行国家返回比利时的人的两种测试的诊断性能。在18个月的时间内，对所有从热带地区返回的疟疾血膜阳性的患者进行了这两种检测。没有明显原因的发热患者作为对照。对于ParaSight（TM）-F测试，仅考虑恶性疟原虫滋养体，灵敏度为95%，特异性为90%。考虑所有疟原虫的滋养体，敏感性为71%，特异性为87%。最后，考虑到临床疟疾患者，该测试的灵敏度为72%，特异性为87%。ICT疟疾Pf（TM）测试，敏感性为95%，特异性为89%，I？恶性疟原虫滋养体感染率分别为71%和86%，临床疟疾为72%和87%。这两个测试给出了高度可比的结果。然而，在诊断输入性疟疾方面，抗原检测分析不能取代传统的显微镜检查。厚血膜检查更敏感，更具体，它可以估计寄生虫血症和寄生虫生长阶段之间的区别，它涵盖了所有物种。此外，对于接受治疗的患者，使用抗原检测可能会导致确定治疗疗效的问题。
The ParaSight(TM)-F dipstick test (Becton Dickinson, USA) and the ICT Malaria Pf(TM) test (ICT, Australia) both detect histidine rich protein 2 (HRP-2), a water-soluble antigen expressed by Plasmodium falciparum trophozoites. The present study compared the diagnostic performance of both tests in persons returning to Belgium from countries endemic for malaria. During a period of 18 months both tests were performed on all patients returning from the tropics with a positive malaria blood film. Patients with fever without an obvious cause were used as controls. For the ParaSight(TM)-F test, considering P. falciparum trophozoites only, sensitivity was 95% and specificity 90%. Considering trophozoites of all species of Plasmodium, sensitivity was 71% and specificity 87%. Finally, considering patients with clinical malaria, the sensitivity of the test was 72% and specificity 87%. For the ICT Malaria Pf(TM) test, sensitivity was 95% and specificity 89% for I? falciparum trophozoites only, 71% and 86% for trophozoites of all species, and 72% and 87% for clinical malaria. Both tests gave highly comparable results. However, antigen detection assays cannot replace conventional microscopy in diagnosing imported malaria. Thick blood film examination is more sensitive and more specific, it allows estimation of parasitaemia and distinction between parasite growth stages, and it covers all species. Moreover, with treated patients the use of antigen tests might lead to problems in determining the efficacy of therapy.