FIND, Geneva, Switzerland.
Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Malar J. 2021 Sep 24;20(1):379. doi: 10.1186/s12936-021-03911-y.
The diagnosis of malaria, using microscopy or rapid diagnostic tests (RDTs), requires the collection of capillary blood. This procedure is relatively simple to perform but invasive and poses potential risks to patients and health workers, arising from the manipulation of potentially infectious bodily fluids. Less or non-invasive diagnostic tests, based on urine, saliva or requiring no sampling, have the potential to generate less discomfort for the patient and to offer simpler and less risky testing procedures that could be safely performed by untrained staff or even self-performed. To explore the potential acceptance and perceived value of such non-invasive tests, an online, international survey was conducted to gather feedback from National Malaria Control Programme (NMCP) representatives.
An online survey comprising nineteen questions, available in English, French or Spanish, was emailed to 300 individuals who work with NMCPs in malaria-endemic countries. Answers were collected between November and December 2017; responses were qualitatively analysed to identify key themes and trends and quantitatively analysed to determine average values stratified by region.
Responses were received from 70 individuals, from 33 countries. Approximately half of the respondents (52 %) considered current blood-based tests for malaria to be minimally invasive and non-problematic in their setting. For these participants, non-invasive tests would only be of interest if they brought additional performance improvements, as compared with the performance of microscopy and RDTs. Most respondents were of the view that saliva-based (80 %) and urine-based (66 %) tests would be more readily acceptable among children than blood-based tests. Potential use-case scenarios of interest for both saliva- and urine-based tests were ease-of-testing by community health workers, additional surveillance, self-testing, and outbreak investigation. Many respondents (41 %) thought that if saliva-based tests retailed at <$0.50 per unit they could largely replace conventional RDTs, whereas only 25 % of respondents thought a similarly priced urine-based test would do so.
Although limited to NMCP stakeholders, this survey indicated that current tests for malaria, based on capillary blood, are generally perceived to be minimally invasive and non-problematic. Non-invasive tests, especially if saliva-based, would be welcome if they could match or out-perform the price and performance of current blood-based tests.
疟疾的诊断，无论是使用显微镜还是快速诊断检测（RDT），都需要采集毛细血管血。虽然这种操作相对简单，但具有侵入性，并且可能对患者和卫生工作者带来潜在风险，因为操作中会涉及到可能具有传染性的体液。基于尿液、唾液的较少侵入性或非侵入性诊断检测，或无需采样的检测，可能会减少患者的不适，并提供更简单、风险更低的检测程序，这些程序可以由未经培训的人员甚至患者自己安全地执行。为了探索这些非侵入性检测方法的潜在接受度和感知价值，我们开展了一项在线国际调查，以收集来自疟疾流行国家国家疟疾控制规划（NMCP）代表的反馈。
我们以英文、法文或西班牙文编写了一份包含 19 个问题的在线调查，并将其电子邮件发送给了 300 名在疟疾流行国家从事 NMCP 工作的人员。我们于 2017 年 11 月至 12 月期间收集了回复；通过定性分析识别关键主题和趋势，并通过定量分析确定按区域划分的平均值。
我们收到了来自 33 个国家的 70 名受访者的回复。大约一半的受访者（52%）认为他们所在环境中当前的疟疾血检具有较小的侵入性且不存在问题。对于这些参与者来说，只有当非侵入性检测在性能上优于显微镜和 RDT 时，才会对其产生兴趣。大多数受访者认为，与血检相比，唾液（80%）和尿液（66%）检测在儿童中更容易被接受。唾液和尿液检测的潜在应用场景包括社区卫生工作者易于检测、额外的监测、自我检测和暴发调查。许多受访者（41%）认为，如果唾液检测的零售价低于 0.50 美元/单位，那么它们可以在很大程度上替代传统的 RDT，而只有 25%的受访者认为价格相当的尿液检测可以做到这一点。
尽管这项调查仅限于 NMCP 利益相关者，但结果表明，目前基于毛细血管血的疟疾检测通常被认为具有较小的侵入性且不存在问题。如果非侵入性检测，特别是基于唾液的检测，能够在价格和性能上与目前基于血液的检测相匹配或优于后者，那么它们将受到欢迎。
