Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina.
Duke Global Health Institute, Duke University, Durham, North Carolina.
Am J Trop Med Hyg. 2020 Feb;102(2):388-391. doi: 10.4269/ajtmh.19-0625.
infections are prevalent in Southeast Asia and northern Australia and often misdiagnosed. Diagnostics are often neither sensitive nor rapid, contributing up to 50% mortality rate. In this 2018 pilot study, we enrolled 100 patients aged 6 months-79 years from Kapit Hospital in Sarawak, Malaysia, with symptoms of infection. We used three different methods for the detection of : a real-time polymerase chain reaction (PCR) assay, a rapid lateral flow immunoassay, and the standard-of-care bacterial culture-the gold standard. Among the 100 participants, 24 (24%) were positive for by one or more of the detection methods. Comparing the two individual diagnostic methods against the gold standard-bacterial culture-of any positive test, there was low sensitivity for each test (25-44%) but high specificity (93-98%). It seems clear that more sensitive diagnostics or a sensitive screening diagnostic followed by specific confirmatory diagnostic is needed for this disease.
感染在东南亚和澳大利亚北部很流行，而且经常被误诊。诊断方法往往既不敏感也不快，导致高达 50%的死亡率。在这项 2018 年的试点研究中，我们从马来西亚砂拉越州的 Kapit 医院招募了 100 名 6 个月至 79 岁的感染症状患者。我们使用三种不同的方法来检测 ：实时聚合酶链反应（PCR）检测、快速侧向流动免疫测定和标准护理细菌培养——金标准。在 100 名参与者中，有 24 名（24%）通过一种或多种检测方法呈 阳性。将两种单独的诊断方法与金标准（细菌培养）相比，任何阳性测试的敏感性都较低（25-44%），但特异性较高（93-98%）。很明显，这种疾病需要更敏感的诊断方法，或者是一种敏感的筛查诊断，然后是特异性的确认诊断。
