Van den Ende J, Vervoort T, Van Gompel A, Lynen L
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Trans R Soc Trop Med Hyg. 1998 May-Jun;92(3):285-8. doi: 10.1016/s0035-9203(98)91013-6.
The ParaSight-F dipstick test (Becton Dickinson, USA) and the ICT Malaria Pf test (ICT, Australia) both detect histidine rich protein 2 (HRP-2), a water-soluble antigen expressed by Plasmodium falciparum trophozoites. The present study compared the diagnostic performance of both tests in persons returning to Belgium from countries endemic for malaria. During a period of 18 months both tests were performed on all patients returning from the tropics with a positive malaria blood film. Patients with fever without an obvious cause were used as controls. For the ParaSight-F test, considering P. falciparum trophozoites only, sensitivity was 95% and specificity 90%. Considering trophozoites of all species of Plasmodium, sensitivity was 71% and specificity 87%. Finally, considering patients with clinical malaria, the sensitivity of the test was 72% and specificity 87%. For the ICT Malaria Pf test, sensitivity was 95% and specificity 89% for P. falciparum trophozoites only, 71% and 86% for trophozoites of all species, and 72% and 87% for clinical malaria. Both tests gave highly comparable results. However, antigen detection assays cannot replace conventional microscopy in diagnosing imported malaria. Thick blood film examination is more sensitive and more specific, it allows estimation of parasitaemia and distinction between parasite growth stages, and it covers all species. Moreover, with treated patients the use of antigen tests might lead to problems in determining the efficacy of therapy.
帕拉西特 - F试纸条检测（美国贝克顿·迪金森公司）和ICT疟疾Pf检测（澳大利亚ICT公司）均能检测富含组氨酸蛋白2（HRP - 2），这是一种由恶性疟原虫滋养体表达的水溶性抗原。本研究比较了这两种检测方法对从疟疾流行国家返回比利时人员的诊断性能。在18个月的时间里，对所有从热带地区返回且疟原虫血涂片呈阳性的患者进行了这两种检测。将无明显病因的发热患者作为对照。对于帕拉西特 - F检测，仅考虑恶性疟原虫滋养体时，敏感性为95%，特异性为90%。考虑所有疟原虫种类的滋养体时，敏感性为71%，特异性为87%。最后，考虑临床疟疾患者时，该检测的敏感性为72%，特异性为87%。对于ICT疟疾Pf检测，仅针对恶性疟原虫滋养体时，敏感性为95%，特异性为89%；针对所有种类滋养体时，敏感性为71%，特异性为86%；针对临床疟疾时，敏感性为72%，特异性为87%。两种检测结果高度可比。然而，抗原检测方法在诊断输入性疟疾时不能替代传统显微镜检查。厚血膜检查更敏感、更具特异性，它能估计疟原虫血症并区分寄生虫生长阶段，且涵盖所有种类。此外，对于接受治疗的患者，使用抗原检测可能会在确定治疗效果方面产生问题。
