Pieroni P, Mills C D, Ohrt C, Harrington M A, Kain K C
Department of Medicine, Toronto Hospital, Canada.
Trans R Soc Trop Med Hyg. 1998 Mar-Apr;92(2):166-9. doi: 10.1016/s0035-9203(98)90730-1.
Rapid and accurate methods are needed for the diagnosis of imported malaria. The ParaSight-F test and the ICT Malaria Pf test are commercially available kits marketed for the diagnosis of Plasmodium falciparum malaria. Both tests are antigen-capture assays based on the detection of P. falciparum histidine-rich protein 2 in peripheral blood. Using microscopy and a polymerase chain reaction (PCR)-based method as reference standards, we performed a 'blinded' comparison of these assays for the detection of P. falciparum infection in 200 febrile travellers returning from malaria-endemic areas. As determined by PCR and microscopy, 148 travellers had malaria and, of these patients, 54.7% (81/148) were infected with P. vivax only, 31.1% (46/148) with P. falciparum only, 9.5% (14/148) with P. ovale, 0.7% (1/148) with P. malariae, and 4.1% (6/148) had mixed infections. Compared to PCR, the ParaSight-F and ICT Malaria Pf tests had initial sensitivities of 94% and 90% and specificities of 95% and 97%, respectively, for the detection of P. falciparum malaria. When discrepant samples were retested with day 0 and day 1 bloods, the sensitivities improved to 96% and 94%, respectively. The 2 remaining false negative results with the Para-Sight-F test and 2 of the 3 false negative results with the ICT Malaria Pf test occurred in samples with < 100 parasites/microL. The performance of these kits was not significantly different (P = 0.75) and both are simple, rapid, and accurate tests for the detection of P. falciparum infection in the returned traveller.
需要快速准确的方法来诊断输入性疟疾。ParaSight - F检测试剂盒和ICT疟疾Pf检测试剂盒是市面上可买到的用于诊断恶性疟原虫疟疾的试剂盒。这两种检测都是基于检测外周血中恶性疟原虫富含组氨酸蛋白2的抗原捕获检测法。我们以显微镜检查和基于聚合酶链反应（PCR）的方法作为参考标准，对这两种检测法在200名从疟疾流行地区归来的发热旅行者中检测恶性疟原虫感染进行了“盲法”比较。经PCR和显微镜检查确定，148名旅行者患有疟疾，在这些患者中，54.7%（81/148）仅感染间日疟原虫，31.1%（46/148）仅感染恶性疟原虫，9.5%（14/148）感染卵形疟原虫，0.7%（1/148）感染三日疟原虫，4.1%（6/148）为混合感染。与PCR相比，ParaSight - F检测试剂盒和ICT疟疾Pf检测试剂盒检测恶性疟原虫疟疾的初始灵敏度分别为94%和90%，特异性分别为95%和97%。当对有差异的样本用第0天和第1天的血液重新检测时，灵敏度分别提高到96%和94%。ParaSight - F检测试剂盒剩余的2例假阴性结果以及ICT疟疾Pf检测试剂盒3例假阴性结果中的2例出现在每微升寄生虫数<100的样本中。这些试剂盒的性能无显著差异（P = 0.75），两者都是检测归来旅行者中恶性疟原虫感染的简单、快速且准确的检测方法。
