Department of Medical Laboratory Science, College of Medicine and Health sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Medical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Infect Dis. 2024 May 14;24(1):492. doi: 10.1186/s12879-024-09369-y.
Malaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women.
A health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen's kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated.
The prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax.
Prevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools.
妊娠疟疾仍然是全球的一个重大公共卫生问题，尤其是在撒哈拉以南非洲地区。在疟疾流行地区，大多数孕妇无症状，但疟疾仍可能对母亲及其后代造成并发症，并且成为传播感染的源头。尽管有这些影响，但在埃塞俄比亚，没有使用高度敏感和特异的实验室诊断工具来诊断无症状疟原虫感染（APIs）。因此，本研究的目的是比较快速诊断试验（RDT）、显微镜检查和实时聚合酶链反应（RT-PCR）在诊断孕妇 API 中的性能。
2019 年 2 月至 3 月，在埃塞俄比亚西北部 Jawi 区 Fendeka 镇卫生设施进行了一项基于卫生保健机构的横断面研究，共纳入 166 名接受产前护理的孕妇。采用便利抽样技术收集参与者的社会人口学特征。采集干血斑（DBS）样本进行分子分析。使用 RDT、显微镜检查和 RT-PCR 诊断孕妇无症状疟原虫感染。采用描述性统计方法确定 API 的流行率。进行方法比较，并使用 Cohen's kappa 系数（k）确定诊断方法之间的一致性程度。还计算了寄生虫密度。
RDT、显微镜检查和 RT-PCR 检测 API 的流行率分别为 9.6%、11.4%和 18.7%。API 的总体比例为 19.3%。RDT 的敏感性为 83.3%，与显微镜检查相比。RDT 和显微镜检查的敏感性分别为 50%和 60%，与 RT-PCR 相比。恶性疟原虫的平均寄生虫密度为 3213 条/µl，间日疟原虫的平均寄生虫密度为 1140 条/µl。
研究区域 API 的流行率较高。与 RT-PCR 相比，RDT 和显微镜检查的敏感性较低。因此，应重视孕妇 API 的常规实验室诊断，并使用更敏感和特异的实验室诊断工具。
