Ogouyèmi-Hounto A, Kinde-Gazard D, Keke C, Gonçalves E, Alapini N, Adjovi F, Adisso L, Bossou C, Denon Y V, Massougbodji A
Bull Soc Pathol Exot. 2013 Feb;106(1):27-31. doi: 10.1007/s13149-012-0264-7. Epub 2012 Oct 10.
The aim of the study was to determine the accuracy of a rapid diagnostic test (SD Bioline Malaria Ag P.f/ Pan®) and fluorescent microscopy (CyScope®) in confirming presumptive malaria diagnosis in Cotonou. Thick blood smear was used as the reference technique for comparison. Testing was conducted on persons between the ages of 6 months and 70 years at two hospitals from June to October 2010. If malaria was suspected in the sample by the nurse based on clinical findings and sent to laboratory for confirmation, one thick smear, one rapid diagnostic test and one slide for the fluorescent microscopy were performed. All tests were read in hospital laboratories involved with the quality control of thick blood smear in the parasitology laboratory of National University Hospital of Cotonou. A total of 354 patients with clinical diagnosis of malaria were included. Malaria prevalence determined by thick smear, rapid diagnostic test and fluorescent microscopy was 22.8%, 25.4%, and 25.1% respectively. The sensitivity, specificity, positive and negative predictive values compared to the thick smears were 96.3, 95.6, 86.7, and 98.9% for rapid diagnostic test; and 97.5, 96.7, 89.8, and 99.27% for fluorescent microscopy. With these performances, these tests meet acceptability standards recommended by WHO for rapid tests (sensitivity > 95%). These two methods have advantages for the confirmation of malaria diagnosis in peripheral health structures that lack the resources to conduct diagnosis confirmation by the thick blood smear.
该研究的目的是确定一种快速诊断检测方法（SD Bioline疟疾抗原P.f/泛氏试剂）和荧光显微镜检查（CyScope）在确认科托努地区疟疾初步诊断中的准确性。厚血涂片被用作比较的参考技术。2010年6月至10月期间，在两家医院对6个月至70岁的人群进行了检测。如果护士根据临床症状怀疑样本中存在疟疾并将其送至实验室进行确认，则进行一张厚涂片、一次快速诊断检测和一张用于荧光显微镜检查的玻片。所有检测均在科托努国立大学医院寄生虫学实验室参与厚血涂片质量控制的医院实验室中进行判读。总共纳入了354例临床诊断为疟疾的患者。通过厚涂片、快速诊断检测和荧光显微镜检查确定的疟疾患病率分别为22.8%、25.4%和25.1%。与厚涂片相比，快速诊断检测的灵敏度、特异度、阳性预测值和阴性预测值分别为96.3%、95.6%、86.7%和98.9%；荧光显微镜检查的相应值分别为97.5%、96.7%、89.8%和99.27%。基于这些表现，这些检测符合世界卫生组织推荐的快速检测可接受标准（灵敏度>95%）。这两种方法对于在缺乏资源通过厚血涂片进行诊断确认的基层卫生机构中确认疟疾诊断具有优势。
