一项系统评价：快速诊断检测在人体血液中检测单纯性 knowlesi 疟原虫、malariae 疟原虫和 ovale 疟原虫感染的性能。

BACKGROUND

Despite the increased use and worldwide distribution of malaria rapid diagnostic tests (RDTs) that distinguish between Plasmodium falciparum and non-falciparum species, little is known about their performance detecting Plasmodium knowlesi (Pk), Plasmodium malariae (Pm), and Plasmodium ovale (Po). This review seeks to analyze the results of published studies evaluating the diagnostic accuracy of malaria RDTs in detecting Pk, Pm, and Po monoinfections.

METHODS

MEDLINE, EMBASE, Web of Science, and CENTRAL databases were systematically searched to identify studies that reported the performance of RDTs in detecting Pk, Pm, and Po monoinfections.

RESULTS

Among 40 studies included in the review, 3 reported on Pk, 8 on Pm, 5 on Po, 1 on Pk and Pm, and 23 on Pm and Po infections. In the meta-analysis, estimates of sensitivities of RDTs in detecting Pk infections ranged 2%-48%. Test performances for Pm and Po infections were less accurate and highly heterogeneous, mainly because of the small number of samples tested.

CONCLUSIONS

Limited data available suggest that malaria RDTs show suboptimal performance for detecting Pk, Pm, and Po infections. New improved RDTs and appropriately designed cross-sectional studies to demonstrate the usefulness of RDTs in the detection of neglected Plasmodium species are urgently needed.

背景

尽管疟原虫快速诊断检测试剂（RDT）的使用和全球分布有所增加，这种试剂能够区分间日疟原虫（Plasmodium falciparum）和非间日疟原虫物种，但对于其检测伯氏疟原虫（Plasmodium knowlesi）、卵形疟原虫（Plasmodium ovale）和三日疟原虫（Plasmodium malariae）的性能知之甚少。本综述旨在分析评估 RDT 检测伯氏疟原虫、卵形疟原虫和三日疟原虫单感染的诊断准确性的已发表研究结果。

方法

系统检索 MEDLINE、EMBASE、Web of Science 和 CENTRAL 数据库，以确定报告 RDT 检测伯氏疟原虫、卵形疟原虫和三日疟原虫单感染性能的研究。

结果

在纳入的 40 项研究中，有 3 项研究报告了伯氏疟原虫感染，8 项研究报告了卵形疟原虫感染，5 项研究报告了三日疟原虫感染，1 项研究报告了伯氏疟原虫和卵形疟原虫感染，23 项研究报告了卵形疟原虫和三日疟原虫感染。在荟萃分析中，RDT 检测伯氏疟原虫感染的敏感性估计值为 2%-48%。检测卵形疟原虫和三日疟原虫感染的检测性能准确性较差且高度异质，主要是因为检测的样本数量较少。