Abdi Moussa Rahma, Papa Mze Nasserdine, Yonis Arreh Houssein, Abdillahi Hamoud Aicha, Mohamed Alaleh Kahiya, Mohamed Aden Fatouma, Yonis Omar Abdoul-Razak, Osman Abdi Warsama, Kayad Guelleh Samatar, Ahmed Abdi Abdoul-Ilah, Basco Leonardo K, Abdi Khaireh Bouh, Bogreau Hervé
Aix Marseille Université, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France.
IHU-Méditerranée Infection, 13005 Marseille, France.
Diagnostics (Basel). 2024 Jan 25;14(3):262. doi: 10.3390/diagnostics14030262.
Until 2020, Djiboutian health authorities relied on histidine-rich protein-2 (HRP2)-based rapid diagnostic tests (RDTs) to establish the diagnosis of . The rapid spread of histidine-rich protein-2 and -3 () gene-deleted parasite strains in Djibouti has led the authorities to switch from HRP2-based RDTs to lactate dehydrogenase (LDH)-based RDTs targeting the plasmodial lactate dehydrogenase (pLDH) specific for and (RapiGEN BIOCREDIT Malaria Ag Pf/Pv pLDH/pLDH) in 2021. This study was conducted with the primary objective of evaluating the diagnostic performance of this alternative RDT. Operational constraints related, in particular, to the implementation of this RDT during the COVID-19 pandemic were also considered. The performance of BIOCREDIT Malaria Ag Pf/Pv (pLDH/pLDH) RDT was also compared to our previously published data on the performance of two HRP2-based RDTs deployed in Djibouti in 2018-2020. The diagnosis of 350 febrile patients with suspected malaria in Djibouti city was established using two batches of RapiGEN BIOCREDIT Malaria Ag Pf/Pv (pLDH/pLDH) RDT over a two-year period (2022 and 2023) and confirmed by real-time quantitative polymerase chain reaction. The sensitivity and specificity for the detection of were 88.2% and 100%, respectively. For , the sensitivity was 86.7% and the specificity was 100%. Re-training and closer supervision of the technicians between 2022 and 2023 have led to an increased sensitivity to detect (69.8% in 2022 versus 88.2% in 2023; < 0.01). The receiver operating characteristic curve analysis highlighted a better performance in the diagnosis of with pLDH-based RDTs compared with previous HRP2-based RDTs. In Djibouti, where -deleted strains are rapidly gaining ground, LDH-based RDTs seem to be more suitable for diagnosing than HRP2-based RDTs. Awareness-raising and training for technical staff have also been beneficial.
直到2020年，吉布提卫生当局一直依靠基于富含组氨酸蛋白2（HRP2）的快速诊断检测（RDT）来确诊疟疾。吉布提富含组氨酸蛋白2和3（ ）基因缺失的疟原虫菌株迅速传播，促使当局在2021年从基于HRP2的RDT转向基于乳酸脱氢酶（LDH）的RDT，该RDT针对疟原虫乳酸脱氢酶（pLDH），对间日疟原虫和恶性疟原虫具有特异性（RapiGEN BIOCREDIT疟疾抗原Pf/Pv pLDH/pLDH）。本研究的主要目的是评估这种替代RDT的诊断性能。还考虑了与在2019冠状病毒病大流行期间实施这种RDT相关的操作限制。BIOCREDIT疟疾抗原Pf/Pv（pLDH/pLDH）RDT的性能也与我们之前发表的关于2018 - 2020年在吉布提部署的两种基于HRP2的RDT性能的数据进行了比较。在两年时间（2022年和2023年）内，使用两批RapiGEN BIOCREDIT疟疾抗原Pf/Pv（pLDH/pLDH）RDT对吉布提市350名疑似疟疾的发热患者进行诊断，并通过实时定量聚合酶链反应进行确认。检测间日疟原虫的灵敏度和特异性分别为88.2%和100%。对于恶性疟原虫，灵敏度为86.7%，特异性为100%。2022年至2023年对技术人员进行再培训和更密切的监督，使得检测间日疟原虫的灵敏度有所提高（2022年为69.8%，2023年为88.2%；P < 0.01）。受试者工作特征曲线分析表明，与之前基于HRP2的RDT相比，基于pLDH的RDT在诊断疟疾方面表现更好。在吉布提，基因缺失菌株迅速蔓延，基于LDH的RDT似乎比基于HRP2的RDT更适合诊断疟疾。对技术人员的宣传和培训也很有帮助。
