Ba H, Ahouidi A D, Duffy C W, Deh Y B, Diedhiou C, Tandia A, Diallo M Y, Assefa S, Lô B B, Elkory M B, Conway D J
Institut national de recherche en santé publique (INRSP), BP 695, Nouakchott, Mauritanie.
Hôpital Le Dantec, Université Cheikh Anta Diop, Dakar, Sénégal.
Bull Soc Pathol Exot. 2017 Feb;110(1):31-37. doi: 10.1007/s13149-017-0541-y. Epub 2016 Dec 29.
Performance of the malaria Rapid Diagnostic Test (RDT) OptiMal-IT® was evaluated in Mauritania where malaria is low and dependent on a short transmission season. Slide microscopy was considered as the reference method of diagnosis. Febrile patients with suspected malaria were recruited from six health facilities, 3 urban and 3 rural, during two periods (December 2011 to February 2012, and August 2012 to March 2013). Overall, 780 patients were sampled, with RDT and thick blood film microscopy results being obtained for 759 of them. Out of 774 slides examined, of which 200 were positive, P. falciparum and P. vivax mono-infections were detected in 63.5% (127) and 29.5% (59), while P. falciparum/P. vivax coinfections were detected in 7% (14). Both species were observed in all study sites, although in significantly different proportions. The proportions of thick blood film and OptiMal-IT® RDT positive individuals was 26.3% and 30.3% respectively. Sensitivity and specificity of OptiMal-IT® RDT were 89% [95% CI, 84.7-93.3] and 91.1% [88.6-93.4]. Positives and negative predictive values were 78.1% [72.2-83.7] and 95.9% [94.1-97.5]. These diagnostic values are similar to those generally reported elsewhere, and support the use of RDTs as the main diagnostic tool for malaria in Mauritanian health facilities. In the future, choice of RDTs to be used must take account of thermostability in a hot, dry environment and their ability to detect P. falciparum and P. vivax.
在疟疾发病率较低且传播季节较短的毛里塔尼亚，对疟疾快速诊断检测（RDT）OptiMal-IT®进行了评估。涂片镜检被视为诊断的参考方法。在两个时间段（2011年12月至2012年2月，以及2012年8月至2013年3月），从6家医疗机构（3家城市的和3家农村的）招募了疑似疟疾的发热患者。总共对780名患者进行了采样，其中759名患者获得了RDT检测结果和厚血膜镜检结果。在检查的774张血片中，有200张呈阳性，恶性疟原虫和间日疟原虫单一感染分别占63.5%（127例）和29.5%（59例），而恶性疟原虫/间日疟原虫混合感染占7%（14例）。在所有研究地点均观察到了这两种疟原虫，尽管比例有显著差异。厚血膜和OptiMal-IT® RDT检测呈阳性的个体比例分别为26.3%和30.3%。OptiMal-IT® RDT的灵敏度和特异度分别为89% [95%置信区间，84.7 - 93.3]和91.1% [88.6 - 93.4]。阳性预测值和阴性预测值分别为78.1% [72.2 - 83.7]和95.9% [94.1 - 97.5]。这些诊断值与其他地方通常报告的结果相似，支持将RDT用作毛里塔尼亚医疗机构疟疾的主要诊断工具。未来，选择使用的RDT必须考虑其在炎热干燥环境中的热稳定性以及检测恶性疟原虫和间日疟原虫的能力。
