Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.
Diagn Pathol. 2013 Apr 15;8:59. doi: 10.1186/1746-1596-8-59.
Diagnosing Plasmodium falciparum malaria during pregnancy is a great challenge for clinicians because of the low density of parasites in the peripheral blood and parasite sequestration in the placenta. Nevertheless, few data on the use of malaria rapid diagnostic test (RDT) during pregnancy have been published.
P. falciparum infections were assessed in 156 febrile pregnant women by microscopic examination of their blood smears and by RDT and polymerase chain reactions (PCR). In addition, 150 women were assessed at the time of delivery by microscopy, RDT, PCR and placental histology investigations. The study was conducted at the Gadarif Hospital, Eastern Sudan. The SD Bioline P. f / P. v (Bio Standard Diagnostics, Gurgaon, Korea) RDT kit was evaluated in this study.
Among the febrile pregnant women, 17 (11.0%), 26 (16.7%) and 18 (11.5%) positive cases of P. falciparum were detected by microscopy, RDT, and PCR, respectively. The sensitivity and specificity of the microscopy was 94.4% and 100%, respectively. The corresponding values for RDT evaluation were 83.3% and 92.0%, as compared with PCR as the gold standard.While there were no detected cases of malaria by microscopic examination of blood smears, 27 (18.0%), 21(14.0%) and 46 (30.7%) out of the 150 placentae investigated had P. falciparum as determined by RDT, PCR, and histology, respectively. The sensitivity and specificity for RDT was 17.4% and 81.7%, respectively. The corresponding values for PCR were 6.5% and 82.7%, where histology was used as the gold standard.
The RDT kit used in this study has poor performance for peripheral and placental P. falciparum malaria detection in this setting.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1092363465928479.
由于外周血寄生虫密度低和胎盘寄生虫隔离，诊断妊娠期间的恶性疟原虫疟疾对临床医生来说是一个巨大的挑战。然而，关于妊娠期间使用疟疾快速诊断检测（RDT）的资料很少。
通过血涂片显微镜检查和 RDT 及聚合酶链反应（PCR）评估 156 例发热孕妇的恶性疟原虫感染。此外，在分娩时，150 名妇女通过显微镜检查、RDT、PCR 和胎盘组织学检查进行评估。这项研究在苏丹东部加达里夫医院进行。在这项研究中评估了 SD Bioline P. f / P. v（Bio Standard Diagnostics，古尔冈，韩国）RDT 试剂盒。
在发热孕妇中，显微镜、RDT 和 PCR 分别检测到 17 例（11.0%）、26 例（16.7%）和 18 例（11.5%）恶性疟原虫阳性病例。显微镜的灵敏度和特异性分别为 94.4%和 100%。RDT 评估的相应值分别为 83.3%和 92.0%，与 PCR 作为金标准相比。虽然通过血涂片显微镜检查未发现疟疾病例，但在 150 例胎盘检查中，RDT、PCR 和组织学分别确定有 27 例（18.0%）、21 例（14.0%）和 46 例（30.7%）有恶性疟原虫。RDT 的灵敏度和特异性分别为 17.4%和 81.7%。PCR 的相应值分别为 6.5%和 82.7%，其中组织学作为金标准。
在本研究中使用的 RDT 试剂盒在这种情况下对检测外周和胎盘恶性疟原虫疟疾的性能较差。
