Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France.
Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France.
Int J Environ Res Public Health. 2024 Feb 15;21(2):228. doi: 10.3390/ijerph21020228.
The first-line diagnosis of malaria in Mali is based on the use of rapid diagnostic tests (RDT) that detect the Histidin Rich Protein 2 (HRP2) antigen specific to . Our study, based on a real-time polymerase chain reaction (qPCR) gold standard, aimed to describe the distribution of the species in each administrative region of Mali and to assess the performance of RDTs.
We randomly selected 150 malaria-negative and up to 30 malaria-positive RDTs in 41 sites distributed in 9 regions of Mali. DNA extracted from the RDT nitrocellulose strip was assayed with a pan- qPCR. Positive samples were then analyzed with -, -, -, or -specific qPCRs.
Of the 1496 RDTs, 258 (18.6%) were positive for spp., of which 96.9% were . The prevalence reached 21.1% in the north. RDT displayed acceptable diagnostic indices; the lower CI95% bounds of Youden indices were all ≥0.50, except in the north (Youden index 0.66 (95% CI [0.44-0.82]) and 0.63 (95% CI [0.33-0.83].
Overall, RDT diagnostic indices are adequate for the biological diagnosis of malaria in Mali. We recommend the use of RDTs detecting -specific antigens in the north.
马里的疟疾一线诊断基于使用快速诊断检测（RDT）来检测特定于 HRP2 抗原的嗜热蛋白 2（HRP2）。我们的研究基于实时聚合酶链反应（qPCR）金标准，旨在描述马里每个行政区域的 物种分布，并评估 RDT 的性能。
我们在马里 9 个地区的 41 个地点随机选择了 150 个疟疾阴性和最多 30 个疟疾阳性的 RDT。从 RDT 硝酸纤维素条上提取的 DNA 用 pan-qPCR 进行检测。对阳性样本进行 -、-、-或 -特异性 qPCR 分析。
在 1496 个 RDT 中，258 个（18.6%）对 spp.呈阳性，其中 96.9%为 。北部的患病率达到 21.1%。RDT 显示出可接受的诊断指标；约登指数的下限 95%CI 均≥0.50，除北部外（约登指数为 0.66（95%CI [0.44-0.82]）和 0.63（95%CI [0.33-0.83]）。
总体而言，RDT 的诊断指标足以用于马里的疟疾生物学诊断。我们建议在北部使用检测 - 特异性抗原的 RDT。
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