University Cheikh Anta Diop, Avenue Cheikh Anta Diop, Dakar, Senegal.
Pathog Glob Health. 2013 Jul;107(5):273-8. doi: 10.1179/2047773213Y.0000000102.
Rapid diagnosis tests (RDTs) allow for the confirmation of malaria diagnosis. In Senegal, RDTs detecting HRP2 have been adopted in 2008 for malaria diagnosis. However, the sustainability of this strategy requires adequate and regular quality control. PCR on DNA extracted in nitrocellulose band of RDTs enable quality control. A RDT (Malaria Antigen P.f®) and a thick smear were performed on patients with suspected malaria. DNA was extracted from the nitrocellulose band of RDTs to which a non-specific PCR and a specific PCR were applied. The results of the RDT were compared with those obtained from the thick smear and the PCR to measure sensitivity, specificity as well as positive and negative predictive values. For 81.6% of the 273 patients involved, the thick smear was positive. Rapid diagnosis tests were positive for 85.7% of the patients. Non-specific PCR was positive on 87.9% of RDTs. Plasmodium falciparum was found in 99.5% of patients and Plasmodium ovale appeared in only 0.4% of patients. Sensitivity of the Malaria Antigen Pf® RDT in relation to thick smear and to PCR was 98.2% and 97.1% respectively. Quality control with PCR on the nitrocellulose band performed several months after it was used confirms its adequate level of sensitivity. The collection and screening of DNA present in already used RDT is a good means of quality control for this tool. It is also a relevant alternative to the molecular approach in the context of a reduction in the transmission of malaria.
快速诊断检测（RDT）可用于确认疟疾诊断。2008 年，塞内加尔采用了检测 HRP2 的 RDT 进行疟疾诊断。然而，该策略的可持续性需要充分和定期的质量控制。从 RDT 的硝酸纤维素带中提取的 DNA 进行 PCR 可实现质量控制。对疑似疟疾患者进行 RDT（疟原虫抗原 P.f®）和厚涂片检测。从 RDT 的硝酸纤维素带中提取 DNA，应用非特异性 PCR 和特异性 PCR。将 RDT 的结果与厚涂片和 PCR 的结果进行比较，以衡量敏感性、特异性以及阳性和阴性预测值。在涉及的 273 名患者中，81.6%的厚涂片呈阳性。85.7%的患者 RDT 检测呈阳性。87.9%的 RDT 非特异性 PCR 呈阳性。99.5%的患者中发现了恶性疟原虫，而卵形疟原虫仅出现在 0.4%的患者中。Malaria Antigen Pf® RDT 与厚涂片和 PCR 的敏感性分别为 98.2%和 97.1%。在使用几个月后，对硝酸纤维素带进行 PCR 的质量控制证实其具有足够的敏感性。收集和筛选已使用的 RDT 中存在的 DNA 是该工具质量控制的一种很好手段。在疟疾传播减少的背景下，它也是分子方法的一个相关替代方法。
