通过基于乳酸脱氢酶疟原虫(pLDH)和富含组氨酸蛋白2(PfHRP-2)的免疫捕获试验诊断输入性疟疾。
Diagnosis of imported malaria by Plasmodium lactate dehydrogenase (pLDH) and histidine-rich protein 2 (PfHRP-2)-based immunocapture assays.
作者信息
Iqbal J, Hira P R, Sher A, Al-Enezi A A
机构信息
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat.
出版信息
Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2):20-3. doi: 10.4269/ajtmh.2001.64.20.
This study was conducted to evaluate the performance of two rapid non-microscopic assays: Plasmodium lactate dehydrogenase (pLDH) assay (OptiMAL) and Plasmodium falciparum histidine-rich protein 2 (PfHRP-2) assay (ICT Malaria). The assays were used to detect malaria infection in 515 immigrants living in Kuwait. The performance of both assays was compared to that of microscopy of Giemsa-stained thick blood films and to each other. Of the 515 patients tested, 163 were positive for malaria parasites by microscopy of thick blood film. Of these, 87 were infected with Plasmodium vivax parasites, 63 with P. falciparum, 1 with Plasmodium malariae, and 12 had mixed infections of P. falciparum and P. vivax. The PfHRP-2 assay detected 53 P. falciparum infections and, as expected, failed to detect all but one case of P. vivax. Three cases of mixed infections were also not detected by this assay. The pLDH assay detected 56 P. falciparum cases and 77 P. vivax infections but failed to detect 4 cases of mixed infections. Compared to microscopy, the performance of both the assays to diagnose P. falciparum infection was comparable. The sensitivity for the PfHRP-2 assay was 82% with a specificity of 99.0% and for the pLDH assay the sensitivity was 89% with a specificity of 99.5%. The PfHRP-2 assay detected 4 false positive cases, 2 of which were also detected by the pLDH assay. These patients reported treatment with chloroquine in the last 2-5 weeks. Though the immunocapture diagnostic assays may be helpful in certain situations, microscopy of thick blood film is still the method of choice in diagnosing imported malaria.
本研究旨在评估两种快速非显微镜检测方法的性能
疟原虫乳酸脱氢酶(pLDH)检测法(OptiMAL)和恶性疟原虫富含组氨酸蛋白2(PfHRP - 2)检测法(ICT Malaria)。这些检测方法用于检测居住在科威特的515名移民中的疟疾感染情况。将这两种检测方法的性能与吉姆萨染色厚血膜显微镜检查的性能进行比较,并相互比较。在接受检测的515名患者中,通过厚血膜显微镜检查发现163人疟原虫呈阳性。其中,87人感染间日疟原虫,63人感染恶性疟原虫,1人感染三日疟原虫,12人同时感染恶性疟原虫和间日疟原虫。PfHRP - 2检测法检测出53例恶性疟原虫感染,正如预期的那样,除1例间日疟原虫感染外,未能检测出其他所有间日疟原虫感染病例。该检测法也未检测出3例混合感染病例。pLDH检测法检测出56例恶性疟原虫病例和77例间日疟原虫感染,但未能检测出4例混合感染病例。与显微镜检查相比,两种检测方法诊断恶性疟原虫感染的性能相当。PfHRP - 2检测法的灵敏度为82%,特异性为99.0%;pLDH检测法的灵敏度为89%,特异性为99.5%。PfHRP - 2检测法检测出4例假阳性病例,其中2例也被pLDH检测法检测出。这些患者报告在过去2 - 5周内接受过氯喹治疗。尽管免疫捕获诊断检测法在某些情况下可能有用,但厚血膜显微镜检查仍然是诊断输入性疟疾的首选方法。