Kojom Foko Loick Pradel, Pande Veena, Singh Vineeta
Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi 110077, India.
Department of Biotechnology, Kumaun University, Bhimtal, Uttarakhand 263001, India.
Diagnostics (Basel). 2021 Mar 25;11(4):590. doi: 10.3390/diagnostics11040590.
Rapid diagnostic tests (RDTs) have become a mainstay of malaria diagnosis in endemic countries since their implementation in the 1990s. We conducted a 30-year systematic review and meta-analysis on malaria RDTs performance in India. Outcomes of interest were sensitivity (Se), specificity (Sp), positive/negative likelihood ratio (PLR/NLR), and diagnostic odd ratio (DOR). Among the 75 studies included, most of the studies were cross-sectional (65.3%), hospital-based (77.3%), and targeted febrile patients (90.6%). Nearly half of RDTs were designed for detecting only (47.5%) while the rest were for and (11.9%), and /Pan- except for (32.3%). When compared to light microscopy (gold standard), pooled estimates of performances were: Se = 97.0%, Sp = 96.0%, PLR = 22.4, NLR = 0.02 and DOR = 1080. In comparison to polymerase chain reaction, the RDTs showed Se = 89.0% and Sp = 99.0%. Performance outcomes (Se and Sp) were similar for RDT targeting only, but decreased for mixed and non-falciparum infections. Performances of malaria RDTs are still high India. However, there is a need for developing RDTs with regard to targeting minor malarial species, individuals carrying only mature gametocytes, and -deleted parasites.
自20世纪90年代投入使用以来，快速诊断检测（RDTs）已成为疟疾流行国家疟疾诊断的主要手段。我们对印度疟疾RDTs的性能进行了为期30年的系统评价和荟萃分析。感兴趣的结果指标为敏感性（Se）、特异性（Sp）、阳性/阴性似然比（PLR/NLR）和诊断比值比（DOR）。在纳入的75项研究中，大多数研究为横断面研究（65.3%）、基于医院的研究（77.3%），且针对发热患者（90.6%）。近一半的RDTs仅设计用于检测（47.5%），其余的用于检测 和 （11.9%），以及 /泛 （除 外，32.3%）。与光学显微镜检查（金标准）相比，性能的合并估计值为：Se = 97.0%，Sp = 96.0%，PLR = 22.4，NLR = 0.02，DOR = 1080。与聚合酶链反应相比，RDTs的Se = 89.0%，Sp = 99.0%。仅针对 的RDTs的性能结果（Se和Sp）相似，但针对混合感染和非恶性疟原虫感染的性能有所下降。印度疟疾RDTs的性能仍然很高。然而，有必要开发针对次要疟原虫种类、仅携带成熟配子体的个体以及 -缺失寄生虫的RDTs。
