Muyidi Ahmed A, Ayashi Musa A, Wakid Majed H, Alghanmi Maimonah S, Baakdah Fadi M, Gattan Hattan S, Alsaady Isra M, Alsulami Muslimah N, Albohiri Haleema H, Altwaim Sarah A, Eisa Zaki M, Brek Thamer M
Main Laboratory and Blood Bank, Medical and Molecular Microbiology Laboratory, King Faisal Medical City for Southern Region, Abha, Saudi Arabia.
Main Laboratory and Blood Bank, Medical and Molecular Microbiology Laboratory, Prince Mohammad Bin Nasser Hospital, Jizan, Saudi Arabia.
J Parasitol Res. 2025 Feb 25;2025:4950793. doi: 10.1155/japr/4950793. eCollection 2025.
Malaria is a deadly vector-borne parasitic disease spread by the bite of an infective female mosquito. In routine malaria diagnosis, microscopic examination is generally regarded as the gold standard. Our study sought to evaluate the diagnostic precision of two commercially accessible quantitative PCR (qPCR) kits, in contrast to light microscopy and nested multiplex PCR (NM-PCR). This cross-sectional study in southwest Saudi Arabia included 92 febrile patients meeting the inclusion criteria. Detection of species used light microscopy, NM-PCR, and qPCR kits (RealStar and Viasure). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) curves were calculated. Statistical analysis was performed using SPSS v25, with significance set at ≤ 0.05. Light microscopy detected 92.4% of cases, NM-PCR detected 73.9%, and RealStar and Viasure detected 92.4% and 95.7%, respectively. Viasure showed the highest sensitivity (97.6%) and NPV (50%), while NM-PCR had superior specificity (71.4%). For species identification, detection was highest with RealStar (85%). Mixed infections were better identified by Viasure (34.6%). RealStar excelled in detection (area under the curve [AUC] = 90%). qPCR detected low parasitemia levels missed by microscopy. The qPCR kits, particularly Viasure, demonstrated superior sensitivity for detecting species and identifying mixed infections compared to light microscopy and NM-PCR. While light microscopy showed higher specificity and PPV, qPCR effectively detected low parasitemia levels missed by microscopy, highlighting its value in improving malaria diagnostics.
疟疾是一种由感染性雌性蚊子叮咬传播的致命媒介传播寄生虫病。在常规疟疾诊断中，显微镜检查通常被视为金标准。我们的研究旨在评估两种商业上可获得的定量聚合酶链反应（qPCR）试剂盒的诊断准确性，并与光学显微镜和巢式多重聚合酶链反应（NM-PCR）进行对比。这项在沙特阿拉伯西南部开展的横断面研究纳入了92名符合纳入标准的发热患者。使用光学显微镜、NM-PCR和qPCR试剂盒（RealStar和Viasure）检测疟原虫种类。计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和受试者工作特征（ROC）曲线。使用SPSS v25进行统计分析，显著性设定为≤0.05。光学显微镜检测出92.4%的病例，NM-PCR检测出73.9%，RealStar和Viasure分别检测出92.4%和95.7%。Viasure显示出最高的敏感性（97.6%）和NPV（50%），而NM-PCR具有更高的特异性（71.4%）。对于疟原虫种类鉴定，RealStar的检测率最高（85%）。Viasure对混合感染的鉴定效果更好（34.6%）。RealStar在疟原虫检测方面表现出色（曲线下面积[AUC]=90%）。qPCR检测出了显微镜检查遗漏的低疟原虫血症水平。与光学显微镜和NM-PCR相比，qPCR试剂盒，尤其是Viasure，在检测疟原虫种类和鉴定混合感染方面表现出更高的敏感性。虽然光学显微镜显示出更高的特异性和PPV，但qPCR有效地检测出了显微镜检查遗漏的低疟原虫血症水平，突出了其在改善疟疾诊断方面的价值。
