Cooke A H, Chiodini P L, Doherty T, Moody A H, Ries J, Pinder M
Department of Clinical Parasitology, The Hospital for Tropical Diseases, London, United Kingdom.
Am J Trop Med Hyg. 1999 Feb;60(2):173-6. doi: 10.4269/ajtmh.1999.60.173.
Microscopic examination of blood smears remains the gold standard for malaria diagnosis, but is labor-intensive and requires skilled operators. Rapid dipstick technology provides a potential alternative. A study was conducted in The Gambia to compare the performance of OptiMAL, an immunochromatographic antigen detection assay for the diagnosis of malaria using parasite lactate dehydrogenase, against standard microscopy in patients with suspected malaria. For initial diagnosis of Plasmodium falciparum, irrespective of stage, this assay had a sensitivity of 91.3%, a specificity of 92%, a positive predictive value of 87.2%, and a negative predictive value of 94.7%. The sensitivity of the test decreased markedly at parasitemias < 0.01%. This assay can be used for the diagnosis of malaria in areas where microscopy is not available and for urgent malaria diagnosis at night and at weekends, when routine laboratories are closed and when relatively inexperienced microscopists may be on duty.
血液涂片的显微镜检查仍然是疟疾诊断的金标准，但这项工作劳动强度大，且需要熟练的操作人员。快速试纸技术提供了一种可能的替代方法。在冈比亚进行了一项研究，比较了OptiMAL（一种使用寄生虫乳酸脱氢酶进行疟疾诊断的免疫层析抗原检测试验）与标准显微镜检查对疑似疟疾患者的诊断性能。对于恶性疟原虫的初步诊断，无论处于哪个阶段，该试验的灵敏度为91.3%，特异性为92%，阳性预测值为87.2%，阴性预测值为94.7%。当疟原虫血症<0.01%时，该试验的灵敏度显著下降。该试验可用于无法进行显微镜检查的地区的疟疾诊断，以及在夜间和周末进行紧急疟疾诊断，此时常规实验室关闭，且可能由经验相对不足的显微镜检查人员值班。
