评估 LED 荧光显微镜在加蓬诊断恶性疟原虫感染中的应用。

Assessment of LED fluorescence microscopy for the diagnosis of Plasmodium falciparum infections in Gabon.

机构信息

Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.

出版信息

Malar J. 2011 Jul 18;10:194. doi: 10.1186/1475-2875-10-194.

DOI:10.1186/1475-2875-10-194

PMID:21767366

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3160428/

Abstract

BACKGROUND

Rapid and accurate diagnosis of malaria is central to clinical management and the prevention of drug-overuse, which may lead to resistance development, toxicity and economic losses. So far, light microscopy (LM) of Giemsa-stained thick blood smears is the gold standard. Under optimal conditions the procedure is fast and reliable; nevertheless a gain in speed would be a great advantage. Rapid diagnosis tests are an alternative, although they cost more and give qualitative instead of quantitative results. Light-emitting diode (LED) fluorescence microscopy (ledFM 400 ×, 1000 ×) may offer a reliable and cheap alternative, which can be used at the point of care.

METHODS

LedFM and conventional fluorescence microscopy (uvFM) were compared to LM in 210 samples from patients with history of fever in the last 24 hours admitted to the Albert Schweitzer Hospital in Lambaréné, Gabon.

RESULTS

Sensitivities were 99.1% for ledFM and 97.0% for uvFM, specificities 90.7% for ledFM 400 × and 92.6% for ledFM 1000 × and uvFM. High agreement was found in Bland-Altman-plot and Kappa coefficient (ledFM 1000 ×: 0.914, ledFM 400 × and uvFM: 0.895). The time to diagnosis for both FM methods was shorter compared to LM (LM: 43 min, uvFM: 16 min, ledFM 1000 ×: 14 min, ledFM 400 ×: 10 min).

CONCLUSION

ledFM is a reliable, accurate, fast and inexpensive tool for daily routine malaria diagnosis and may be used as a point of care diagnostic tool.

摘要

背景

快速准确的疟疾诊断是临床管理和预防药物滥用的核心，药物滥用可能导致耐药性发展、毒性和经济损失。到目前为止，吉姆萨染色厚血涂片的光学显微镜（LM）是金标准。在最佳条件下，该程序快速可靠；然而，速度的提高将是一个巨大的优势。快速诊断测试是一种替代方法，尽管它们成本更高，并且给出定性而不是定量的结果。发光二极管（LED）荧光显微镜（ledFM 400×，1000×）可能提供一种可靠且廉价的替代方法，可以在护理点使用。

方法

在 210 份来自过去 24 小时内有发热病史的患者样本中，将 ledFM 和传统荧光显微镜（uvFM）与 LM 进行了比较，这些患者被收入加蓬兰巴雷内的艾伯特·施韦策医院。

结果

ledFM 的敏感性为 99.1%，uvFM 的敏感性为 97.0%，ledFM 400×的特异性为 90.7%，ledFM 1000×和 uvFM 的特异性为 92.6%。 Bland-Altman 图和 Kappa 系数显示出高度一致性（ledFM 1000×：0.914，ledFM 400×和 uvFM：0.895）。与 LM 相比，两种 FM 方法的诊断时间更短（LM：43 分钟，uvFM：16 分钟，ledFM 1000×：14 分钟，ledFM 400×：10 分钟）。