在低传播率的高原地区，显微镜检查会低估有症状个体中恶性疟原虫感染的频率。
Microscopy underestimates the frequency of Plasmodium falciparum infection in symptomatic individuals in a low transmission highland area.
作者信息
Menge David M, Ernst Kacey C, Vulule John M, Zimmerman Peter A, Guo Hongfei, John Chandy C
机构信息
Center for Infectious Diseases and Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota 55455, USA.
出版信息
Am J Trop Med Hyg. 2008 Aug;79(2):173-7.
In an area with unstable malaria transmission, detection of Plasmodium falciparum infection in 379 symptomatic individuals was assessed by microscopy and three polymerase chain reaction (PCR) methodologies. P. falciparum infection was detected in 25% of patients by microscopy, 37% by nested PCR, 41% by merozoite surface protein-2 (MSP-2) PCR, and 45% by a ligase detection reaction-fluorescent microsphere assay (LDR-FMA). Of the 64 individuals who were LDR-FMA positive, microscopy negative and did not receive treatment, 8 (12.5%) had persistent symptoms and returned for treatment. Malaria attributable fraction (MAF) in symptomatic individuals was 14.6% by microscopy (95% confidence interval [CI] = 6.6-21.8%) and 28.2% by nested PCR (95% CI = 17.9-37.2%). In this highland area, P. falciparum infection in symptomatic individuals is detected more frequently by PCR than microscopy, and most frequently by LDR-FMA. P. falciparum infection appears to resolve without treatment in most LDR-FMA-positive, microscopy-negative individuals, but is persistent in a subset of these individuals and requires treatment.
在疟疾传播不稳定的地区，通过显微镜检查和三种聚合酶链反应（PCR）方法评估了379名有症状个体中恶性疟原虫感染情况。通过显微镜检查在25%的患者中检测到恶性疟原虫感染，通过巢式PCR检测到37%，通过裂殖子表面蛋白-2（MSP-2）PCR检测到41%，通过连接酶检测反应-荧光微球测定法（LDR-FMA）检测到45%。在64名LDR-FMA检测呈阳性、显微镜检查呈阴性且未接受治疗的个体中，有8人（12.5%）持续有症状并回来接受治疗。有症状个体中疟疾归因分数（MAF）通过显微镜检查为14.6%（95%置信区间[CI]=6.6-21.8%），通过巢式PCR为28.2%（95%CI=17.9-37.2%）。在这个高地地区，有症状个体中的恶性疟原虫感染通过PCR检测比显微镜检查更频繁，而通过LDR-FMA检测最为频繁。在大多数LDR-FMA检测呈阳性、显微镜检查呈阴性的个体中，恶性疟原虫感染似乎未经治疗就自行消退了，但在这些个体的一部分中感染持续存在且需要治疗。
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