Am J Trop Med Hyg. 2012 Dec;87(6):1004-1011. doi: 10.4269/ajtmh.2012.12-0215. Epub 2012 Oct 22.
Malaria rapid diagnostic tests (RDTs) are known to yield false-positive results, and their use in epidemiologic surveys will overestimate infection prevalence and potentially hinder efficient targeting of interventions. To examine the consequences of using RDTs in school surveys, we compared three RDT brands used during a nationwide school survey in Kenya with expert microscopy and investigated the cost implications of using alternative diagnostic approaches in identifying localities with differing levels of infection. Overall, RDT sensitivity was 96.1% and specificity was 70.8%. In terms of classifying districts and schools according to prevalence categories, RDTs were most reliable for the < 1% and > 40% categories and least reliable in the 1-4.9% category. In low-prevalence settings, microscopy was the most expensive approach, and RDT results corrected by either microscopy or polymerase chain reaction were the cheapest. Use of polymerase chain reaction-corrected RDT results is recommended in school malaria surveys, especially in settings with low-to-moderate malaria transmission.
疟疾快速诊断检测（RDT）已知会产生假阳性结果，在流行病学调查中使用它们会高估感染率，并可能阻碍干预措施的有效实施。为了研究在学校调查中使用 RDT 的后果，我们比较了肯尼亚全国性学校调查中使用的三种 RDT 品牌与专家显微镜检查，并研究了在确定具有不同感染水平的地区时使用替代诊断方法的成本影响。总的来说，RDT 的敏感性为 96.1%，特异性为 70.8%。就根据流行率类别对地区和学校进行分类而言，RDT 在<1%和>40%类别中最可靠，而在 1-4.9%类别中最不可靠。在低流行率环境中，显微镜检查是最昂贵的方法，而通过显微镜或聚合酶链反应校正的 RDT 结果则最便宜。在学校疟疾调查中，建议使用聚合酶链反应校正的 RDT 结果，尤其是在疟疾传播率低至中等的环境中。
