Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Departments of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Ann Afr Med. 2023 Oct-Dec;22(4):470-480. doi: 10.4103/aam.aam_220_21.
Given the challenges of microscopy, we compared its performance with SD-Bioline malaria rapid diagnostic test (MRDT) and polymerase chain reaction (PCR) and evaluated the time it took for positive results to become negative after treatment of children with acute uncomplicated malaria.
We present the report of 485 participants with complete MRDT, microscopy, and PCR data out of 511 febrile children aged 3-59 months who participated in a cohort study over a 12-month period in rural and urban areas of Ibadan, Nigeria. MRDT-positive children received antimalaria and tested at every visit over 28 days. Speciation was also carried out by PCR.
With microscopy as the gold standard, SD-Bioline™ had 95.2% sensitivity, 66.4% specificity, 67.5% positive predictive value (PPV), and 94.9 negative predictive value (NPV), while with PCR the findings were 84.3% sensitivity, 66.5% specificity, 72.7% PPV, and 80.1% NPV. PCR speciation of malaria parasites revealed 91.6% Plasmodium falciparum, 18.9% Plasmodium malariae, and 4.4% Plasmodium ovale. Among the 47 children with P. malariae infections, 66.0% were coinfected with P. falciparum, while 54.6% cases of P. ovale occurred as coinfections with P. falciparum. The median time to a negative MRDT was 23.2 days, while the median time to a negative malaria microscopy was 3.8 days. The two survival curves were significantly different.
The SD-Bioline MRDT performed well, with remarkable persistence of rapid test-positive for an average of 23 days post treatment. The prevalence of P. malaria is somewhat greater than expected.
鉴于显微镜检查的挑战，我们比较了其性能与 SD-Bioline 疟疾快速诊断检测（MRDT）和聚合酶链反应（PCR），并评估了儿童急性无并发症疟疾治疗后阳性结果转为阴性所需的时间。
我们报告了一项研究结果，该研究纳入了尼日利亚伊巴丹农村和城市地区在 12 个月期间参加队列研究的 511 名发热儿童中的 485 名具有完整 MRDT、显微镜和 PCR 数据的参与者。MRDT 阳性的儿童接受抗疟药物治疗，并在 28 天的每个就诊时进行检测。PCR 还进行了分类。
以显微镜为金标准，SD-Bioline™的灵敏度为 95.2%，特异性为 66.4%，阳性预测值（PPV）为 67.5%，阴性预测值（NPV）为 94.9%，而 PCR 的结果为 84.3%的灵敏度，66.5%的特异性，72.7%的 PPV 和 80.1%的 NPV。疟原虫 PCR 分类显示 91.6%为恶性疟原虫，18.9%为间日疟原虫，4.4%为卵形疟原虫。在 47 例间日疟原虫感染的儿童中，66.0%为恶性疟原虫合并感染，而 54.6%卵形疟原虫感染为恶性疟原虫合并感染。MRDT 转为阴性的中位数时间为 23.2 天，而疟原虫镜检转为阴性的中位数时间为 3.8 天。这两条生存曲线有显著差异。
SD-Bioline MRDT 表现良好，治疗后平均 23 天快速检测阳性持续存在。间日疟原虫的流行率略高于预期。
