Abdalla Zakya A, Rahma NourElhouda A, Hassan Elhashimi E, Abdallah Tajeldin M, Hamad Hadeel E, Omer Samia A, Adam Ishag
University of Bahri, Bahri, Sudan.
College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.
Trans R Soc Trop Med Hyg. 2019 Nov 1;113(11):701-705. doi: 10.1093/trstmh/trz069.
Accurate diagnosis of malaria infection is essential for successful control and management of the disease. Both microscopy and rapid diagnostic tests (RDTs) are recommended for malaria diagnosis, however, RDTs are more commonly used. The aim of the current study was to assess the performance of microscopy and RDTs in the diagnosis of Plasmodium falciparum infection using a nested polymerase chain reaction (PCR) assay as the gold standard.
A cross-sectional study was carried out in Kassala Hospital, eastern Sudan. A total of 341 febrile participants of all ages were recruited. Blood specimens were collected and malaria testing was performed using an RDT (SD Bioline Malaria Ag Pf), microscopy and nested PCR. The sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) of microscopy and the RDT were investigated.
The prevalence of P. falciparum malaria infections in this study was 22.9%, 24.3% and 26.7% by PCR, microscopy and RDT, respectively. Compared with microscopy, the RDT had slightly higher sensitivity (80.7% vs 74.3%; p=0.442), equivalent specificity (89.3% vs 90.4%), a similar PPV (69.2% vs 69.8%) and a higher NPV (94.0% vs 92.2%).
The diagnostic performance of the RDT was better than that of microscopy in the diagnosis of P. falciparum malaria when nested PCR was used as the gold standard.
准确诊断疟疾感染对于成功控制和管理该疾病至关重要。显微镜检查和快速诊断检测（RDT）均推荐用于疟疾诊断，但RDT使用更为普遍。本研究的目的是使用巢式聚合酶链反应（PCR）检测作为金标准，评估显微镜检查和RDT在诊断恶性疟原虫感染中的性能。
在苏丹东部的卡萨拉医院开展了一项横断面研究。共招募了341名各年龄段的发热参与者。采集血液样本，并使用RDT（SD Bioline疟疾抗原Pf）、显微镜检查和巢式PCR进行疟疾检测。研究了显微镜检查和RDT的敏感性、特异性、阳性和阴性预测值（分别为PPV和NPV）。
本研究中，通过PCR、显微镜检查和RDT检测，恶性疟原虫疟疾感染率分别为22.9%、24.3%和26.7%。与显微镜检查相比，RDT的敏感性略高（80.7%对74.3%；p=0.442），特异性相当（89.3%对90.4%），PPV相似（69.2%对69.8%），NPV更高（94.0%对92.2%）。
当以巢式PCR作为金标准时，RDT在诊断恶性疟原虫疟疾方面的诊断性能优于显微镜检查。
