Jahja Natalia Erica, Huwae Irene Ratridewi, B Nara Mario, Harley Adinda, Widaningrum Tarina, Fitri Loeki Enggar
Department of Pediatrics, Dr. Saiful Anwar Hospital/Faculty of Medicine, University of Brawijaya, Jalan J.A Suprapto No. 2 Malang, East Java 65141, Indonesia.
Department of Pediatrics, Dr. TC. Hillers Hospital, Jalan Wairklau Maumere, East Nusa Tenggara 86111, Indonesia.
Malays J Med Sci. 2014 Sep-Oct;21(5):17-23.
Microscopic detection is the conventional method for detecting malaria parasites. Although it is efficient and inexpensive, it has its limitations. In recent years, polymeras chain reaction (PCR) has been considered superior to microscopy in detecting mixed Plasmodium infections or infections with low parasite density. To determine whether microscopic or nested PCR (nPCR) is better at detecting congenital malaria (CM).
Blood smear examination and nPCR were performed with blood samples taken from mothers and their newborns, who were likely to be suffering from CM and in whom one of the symptoms was low birth weight (LBW). The sensitivity and specificity of each method were then compared.
During one year of study, the prevalence of CM among 92 LBW newborns was determined to be 6.8% using microscopy and 7.8% using nPCR. Among the 92 mother-infant paired subjects, CM was detected in 34 subjects (37%) by microscopy and in 39 subjects (42.4%) by nPCR. nPCR was more sensitive (76.5% vs 66.7%) but less specific (77.6% vs 84.9%) than microscopy. When the two methods were compared, nPCR gave significantly better results in diagnosing CM (AUC = 0.770; P < 0.001).
Although microscopy remains the most appropriate method for the diagnosis of CM in remote areas, nPCR can be considered a complementary test.
显微镜检测是检测疟原虫的传统方法。尽管它高效且成本低廉，但也有其局限性。近年来，聚合酶链反应（PCR）在检测混合疟原虫感染或低寄生虫密度感染方面被认为优于显微镜检测。为了确定显微镜检测或巢式PCR（nPCR）在检测先天性疟疾（CM）方面哪种方法更好。
对可能患有CM且其中一个症状为低出生体重（LBW）的母亲及其新生儿采集的血样进行血涂片检查和nPCR检测。然后比较每种方法的敏感性和特异性。
在为期一年的研究中，使用显微镜检测确定92例低出生体重新生儿中CM的患病率为6.8%，使用nPCR检测为7.8%。在92对母婴配对对象中，通过显微镜检测在34例对象（37%）中检测到CM，通过nPCR检测在39例对象（42.4%）中检测到CM。nPCR比显微镜检测更敏感（76.5%对66.7%）但特异性更低（77.6%对84.9%）。当比较这两种方法时，nPCR在诊断CM方面的结果明显更好（AUC = 0.770；P < 0.001）。
尽管显微镜检测仍然是偏远地区诊断CM的最合适方法，但nPCR可被视为一种补充检测方法。
