尼日利亚中北部一家三级医院对无症状孕妇进行疟疾超敏和传统快速诊断检测的诊断准确性比较。

Comparison of diagnostic accuracy of ultra-sensitive and conventional rapid diagnostic tests for malaria in asymptomatic pregnant women at a tertiary hospital in North-Central Nigeria.

作者信息

Anenga Ushakuma Michael, Swende Terrumun Zaiyol, Hembah-Hilekaan Samuel Kuma

机构信息

Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Nigeria.

出版信息

Niger Med J. 2025 Jun 16;66(2):489-499. doi: 10.71480/nmj.v66i2.638. eCollection 2025 Mar-Apr.

DOI:10.71480/nmj.v66i2.638

PMID:40703871

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12280291/

Abstract

BACKGROUND

Malaria in pregnancy continues to be a major public health problem in sub-Saharan Africa. Pregnant women are at a higher risk because asymptomatic malaria infections may lead to detrimental pregnancy outcomes. Early diagnosis is the main strategy to reduce these adverse outcomes; however, conventional rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. There are prospects that ultra-or highly sensitive RDTs may improve the detection of malaria in these populations. The objective of this study is to assess and compare the diagnostic accuracy of ultrasensitive and conventional RDTs for malaria in asymptomatic pregnant women at the Benue State University Teaching Hospital, Makurdi.

METHODOLOGY

This was a cross-sectional comparative study conducted in the antenatal clinic of Benue State University Teaching Hospital, Makurdi, Nigeria. It involved 107 asymptomatic pregnant women whose peripheral venous blood samples were obtained and tested with conventional RDT (co-RDT) and ultra-sensitive RDT (us-RDT) to detect Plasmodium falciparum in peripheral blood. The results from microscopy were used as the reference standard. Results were categorised as positive and negative.

RESULTS

The overall prevalence rate of P. falciparum was 14% using microscopy, followed by us-RDT (12.1%) and co-RDT (2.8%). The us-RDT showed a higher sensitivity (66.7% vs. 13.3%), positive predictive value (83.3% vs. 50.0%), negative predictive value (94.7% vs. 87.4%), and test accuracy (93.5% vs. 86.0%) compared to co-RDT. In comparison, the specificity of both tests was similar (97.8%). There was a significant difference in diagnostic performance between the two RDTs (p=0.002).

CONCLUSION

The study suggests that ultrasensitive RDTs are a more effective test for detecting P. falciparum infection in asymptomatic pregnant women compared to conventional RDTs. This may have important implications for clinical decision-making and the management of malaria in pregnancy.

摘要

背景

妊娠疟疾仍是撒哈拉以南非洲地区的一个主要公共卫生问题。孕妇面临更高风险，因为无症状疟疾感染可能导致不良妊娠结局。早期诊断是减少这些不良后果的主要策略；然而，传统的快速诊断检测（RDT）不足以检测低密度感染。超灵敏或高灵敏度的RDT有可能改善这些人群中疟疾的检测。本研究的目的是评估和比较超灵敏和传统RDT在马库尔迪贝努埃州立大学教学医院无症状孕妇中诊断疟疾的准确性。

方法

这是一项在尼日利亚马库尔迪贝努埃州立大学教学医院产前诊所进行的横断面比较研究。研究纳入了107名无症状孕妇，采集其外周静脉血样本，并用传统RDT（co-RDT）和超灵敏RDT（us-RDT）检测外周血中的恶性疟原虫。显微镜检查结果用作参考标准。结果分为阳性和阴性。

结果

使用显微镜检查，恶性疟原虫的总体患病率为14%，其次是us-RDT（12.1%）和co-RDT（2.8%）。与co-RDT相比，us-RDT显示出更高的灵敏度（66.7%对13.3%）、阳性预测值（83.3%对50.0%）、阴性预测值（94.7%对87.4%）和检测准确性（93.5%对86.0%）。相比之下，两种检测的特异性相似（97.8%）。两种RDT的诊断性能存在显著差异（p=0.002）。