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将喀麦隆西部地区无症状患者中广泛使用的快速诊断检测卡瑞思达™(CareStart™)与显微镜检查法进行检测的性能评估。

Performance assessment of a widely used rapid diagnostic test CareStart™ compared to microscopy for the detection of in asymptomatic patients in the Western region of Cameroon.

作者信息

Bamou Roland, Nematchoua-Weyou Zidedine, Lontsi-Demano Michel, Ningahi Laura Gilberine, Tchoumbou Melanie Adèle, Defo-Talom Blaise Armand, Mayi Marie Paul Audrey, Tchuinkam Timoléon

机构信息

Vector Borne Diseases Laboratory of the Applied Biology and Ecology Research Unit (VBID-URBEA), Department of Animal Biology, Faculty of Science of the University of Dschang, P.O. Box 067, Cameroon.

Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B. P.288 Yaoundé, Cameroon.

出版信息

Heliyon. 2021 Feb 14;7(2):e06271. doi: 10.1016/j.heliyon.2021.e06271. eCollection 2021 Feb.

Abstract

While malaria remains a serious public health concern, its rapid or prompt diagnosis in remote areas is important in the fight against the disease. The study aimed to evaluate the performance of widely used Rapid Diagnostic Test (RDT) kits for routinely detection of asymptomatic patients. A total of 400 asymptomatic participants of both sexes aged between 1-89 years from Menoua Division (Santchou and Dschang) were tested for malaria infection using both microscopy and CareStart™ RDT. The prevalence of malaria was higher when using the standard gold tool (Microscopy) (26.0%) compared to RDT (21.8%) with a significant difference (P < 0.05). However, a strong agreement was observed between both tests (kappa = 0.883; P < 0.0001). RDT CareStart™ sensitivity and specificity were 83.65% and 100% respectively while the positive predictive value and negative predictive value were 100% and 95.57% respectively. RDT sensitivity increased with parasite density while false negative (40.4%; n = 17) were observed only when parasite density was low (<500 parasites per microliter of blood). RDT kits appear to be good tools in areas where malaria diagnosis through microscopy is not feasible. However, the low sensibility observed when parasite density is low could be a concern.

摘要

尽管疟疾仍然是一个严重的公共卫生问题,但在偏远地区对其进行快速诊断对于抗击该疾病至关重要。本研究旨在评估广泛使用的快速诊断检测(RDT)试剂盒对无症状患者进行常规检测的性能。使用显微镜检查和CareStart™ RDT对来自梅努阿省(桑楚和贾恩)的400名年龄在1至89岁之间的无症状男女参与者进行了疟疾感染检测。与RDT(21.8%)相比,使用标准金标准工具(显微镜检查)时疟疾患病率更高(26.0%),差异有统计学意义(P < 0.05)。然而,两种检测方法之间观察到高度一致性(kappa = 0.883;P < 0.0001)。CareStart™ RDT的敏感性和特异性分别为83.65%和100%,而阳性预测值和阴性预测值分别为100%和95.57%。RDT的敏感性随寄生虫密度增加而增加,仅在寄生虫密度较低(每微升血液中<500个寄生虫)时观察到假阴性(40.4%;n = 17)。在无法通过显微镜进行疟疾诊断的地区,RDT试剂盒似乎是很好的工具。然而,当寄生虫密度较低时观察到的低敏感性可能是一个问题。

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