乌干达阿帕克和基延东戈地区牛锥虫鉴定的快速诊断测试与基于聚合酶链反应的诊断检测方法的比较评估：一项横断面研究

Comparative evaluation of rapid diagnostic test and PCR-based diagnostic assay for identification of trypanosomes in cattle of Apac and Kiryandongo districts, Uganda: A cross sectional study.

作者信息

Kizza Daniel, Azuba Rose, Wampande Eddie, Okwasiimire Rodney, Owembabazi Lillian, Mandela Wangoola, Waiswa Charles, Odoi Agricola

机构信息

Department of Livestock and Industrial Resources, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.

Department of Agricultural and Environmental Sciences, School of Agricultural and Applied Sciences, Bugema University, Luweero, Uganda.

出版信息

BMC Vet Res. 2024 Dec 19;20(1):570. doi: 10.1186/s12917-024-04436-7.

DOI:10.1186/s12917-024-04436-7

PMID:39696308

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658059/

Abstract

BACKGROUND

Diagnostic tests and knowledge of their diagnostic accuracies are important for animal trypanosomosis surveillance and treatment.

METHODOLOGY

A cross-sectional study was conducted in November 2021 to compare the performance of rapid diagnostic test (RDT) and PCR-based assay for the detection of trypanosome infections. Random sampling and probability proportional to size sampling were used to sample study households and animals from the sampled household respectively. Animals were screened for the presence of trypanosomes using both tests. A total of 100 cattle (52 from Apac and 48 from Kiryandongo districts) were included in the study. The percentage of positive tests, sensitivity, and specificity of the tests using mini PCR as a reference were computed. Cohen's kappa statistics was computed to assess how well the rapid diagnostic test agrees with the mini PCR. McNemar's statistic assessed if the proportion of positive tests identified by mini PCR significantly differed from that identified by the rapid diagnostic test.

RESULTS

The mini PCR test detected 31.2% Trypanosome spp positive samples in Kiryandongo while it detected only 5.7% positive samples in Apac district. The rapid diagnostic test (RDT) analysis detected 91.6% Trypanosome spp positive samples in Kiryandongo district and only 46.1% in Apac district. T. congolense was the most common Trypanosoma species identified in Apac (36.5%) and Kiryandongo (47.9%) by the RDT. The percentage of each of the Trypanosome species (T.vivax, T.congolense, and mixed infection of T.vivax and T. congolense) detected by RDT differed significantly (p < 0.001) between the two districts. The RDT had a high sensitivity of 94.4% (95% Confidence Interval (CI): 72.7-99.9) but a very low specificity of 36.6% (95% CI: 26.2-48.0). The kappa test showed evidence of only a slight agreement (kappa = 0.1547, Accuracy = 0.48 (95% Confidence Interval (CI): 0.379,0.5822) between the two tests. The observed agreement between the tests was 47% while the expected agreement was 37.84%.

CONCLUSION

This study found high sensitivity but low specificity of RDT using mini PCR as a reference.

摘要

背景

诊断测试及其诊断准确性的知识对于动物锥虫病的监测和治疗至关重要。

方法

2021年11月进行了一项横断面研究，以比较快速诊断测试（RDT）和基于PCR的检测方法在检测锥虫感染方面的性能。分别采用随机抽样和与规模成比例的概率抽样方法对研究家庭和从抽样家庭中选取的动物进行抽样。使用这两种检测方法对动物进行锥虫检测。共有100头牛（52头来自阿帕克区，48头来自基延东戈区）纳入本研究。计算以微型PCR为参照的检测方法的阳性检测率、敏感性和特异性。计算科恩kappa统计量，以评估快速诊断测试与微型PCR的一致性程度。使用麦克尼马尔统计量评估微型PCR检测出的阳性检测比例与快速诊断测试检测出的阳性检测比例是否存在显著差异。

结果

微型PCR检测到基延东戈区31.2%的锥虫属阳性样本，而在阿帕克区仅检测到5.7%的阳性样本。快速诊断测试（RDT）分析在基延东戈区检测到91.6%的锥虫属阳性样本，在阿帕克区仅检测到46.1%。通过RDT检测，刚果锥虫是在阿帕克区（36.5%）和基延东戈区（47.9%）鉴定出的最常见锥虫种类。两个区通过RDT检测到的每种锥虫种类（活泼锥虫、刚果锥虫以及活泼锥虫和刚果锥虫混合感染）的比例存在显著差异（p < 0.001）。RDT具有94.4%的高敏感性（95%置信区间（CI）：72.7 - 99.9），但特异性非常低，为36.6%（95% CI：26.2 - 48.0）。kappa检验表明两种检测方法之间仅有轻微一致性（kappa = 0.1547，准确性 = 0.48（95%置信区间（CI）：0.379,0.5822））。两种检测方法之间观察到的一致性为47%，而预期一致性为37.84%。