快速免疫色谱测试法诊断恶性疟的初步观察

目的：评价快速免疫色谱测试法（ＩＣＴ）在我国疟区门诊疟疾的适用性。方法：以镜检结果为对照，用ＩＣＴ方法检测门诊“四热”病人中的恶性疟。结果：ＩＣＴ检测恶性疟的敏感性和特异性分别为９４．７％和９０．３％，与间日疟无交叉，检测不同性别和民族人群阳性率间的差别无显著意义。结论：ＩＣＴ较镜检诊断恶性疟更为快速且简便，更适于在疟区门诊应用。     

快速免疫色谱测试卡诊断恶性疟和间日疟的效果评价

目的： 评价快速免疫色谱测试卡（ Ｉ Ｃ Ｔ） 在疟区诊断恶性疟和间日疟的效果。方法： 以疟原虫镜检结果为标准, 用 Ｉ Ｃ Ｔ 检测门诊“四热”病人中的恶性疟和间日疟。结果： Ｉ Ｃ Ｔ 检测恶性疟与间日疟的敏感性分别为９６７ ％ 和９０４ ％ , 特异性为９８６ ％ 。与原虫镜检结果的符合率为９４７ ％ 。恶性疟与间日疟之间无交叉反应。结论： 免疫色谱测试卡可同时检测恶性疟和间日疟, 较镜检法快速、简易。     

双重免疫色谱技术检测恶性疟和间日疟的初步观察

用双重免疫色谱技术（ＩＣＴ）对疟区门诊的“四热”病人进行疟疾检查,以镜检结果为对照,评价ＩＣＴ诊断疟疾的效果。检测９３例,敏感度和特异性恶性疟为９１．７％和９４．７％,间日疟为８８．２％和１００％,两者之间无交叉反应。显示双重ＩＣＴ检测疟疾快速简便,准确性高,且能区分虫种,具有广阔的应用前景。     

两种方法检测富组蛋白Ⅱ诊断恶性疟的比较

在海南疟区门诊对检测ＨＲＰ－Ⅱ诊断恶性疟的ＰａｒａＳｉｇｈｔ－Ｆ及ＩＣＴ两种方法进行了比较，ＰａｒｎＳｉｇｈｔ－Ｆ方法的敏感度和特异度分别为１００％和８７．１％，ＩＣＴ则为９４．７％和９０．３％，两种方法均比显微镜检查简单易学，快速方便。但ＨＲＰ－Ⅱ仅存在于恶性疟，限制了其在我国广大疟区的应用。     

两种方法检测富组蛋白Ⅱ诊断恶性疟的比较

在海南疟区门诊对检测ＨＲＰ－Ⅱ诊断恶性疟的ＰａｒａＳｉｇｈｔ－Ｆ及ＩＣＴ两种方法进行了比较。ＰａｒａＳｉｇｈｔ－Ｆ方法的敏感度和特异度分别为１００％和８７．１％,ＩＣＴ则为９４．７％和９０．３％;两种方法均比显微镜检查简单易学,快速方便。但ＨＲＰ－Ⅱ仅存在于恶性疟,限制了其在我国广大疟区的应用     

应用巢式PCR评价低流行区疟疾诊断结果

目的初步评价大连市疾控人员对疟疾的诊断能力,为低流行区疟疾诊断方法的选择提供理论依据。方法收集2010--2012年大连市上报的27例疟疾阳性病例的血液样本．应用巢式PCR（nest—PCR）方法对诊断结果进行复核：以复核结果为标准,比较镜检和快速诊断试剂盒（rapid diagnosistest．RDT）方法的检测敏感性及对虫种鉴定的正确率。结果27份样本的巢式PCR结果为恶性疟23份,间日疟2份,卵形疟l份,阴性1份,无混合感染。镜检对阳性样本的敏感度为76．9％（20／26）,远低于RDT方法的96．2％（25／26）;镜检和RDT联合使用,敏感度可达100％。对虫种的鉴别,镜检对阳性样本的正确检测率为50％（13／26）：RDT方法仅能鉴别恶性疟和非恶性疟．对恶性疟阳性样本的正确检测率为100％（23／23）。结论采用镜检和RDT联合应用的方法,能够提高检测的敏感性。建议在有条件的疾控单位建立人体疟原虫的分子检测体系．更有效地防止对疟疾病例的漏诊和误诊。     

试条法快速诊断恶性疟的研究

目的 :探讨试条法检测恶性疟患者血液中富组氨酸蛋白 快速诊断恶性疟在海南疟区现场的诊断价值。方法 :用试条法检测 66例发热病人血样 ,将结果同血涂片镜检法进行比较。结果 :试条法检出恶性疟 (包括混合感染 )的敏感度和特异度分别为 85.7%和95.6% ,两种检测法的符合率为 92 .4 % ;用试条法检测 2 0例间日疟患者血样无交叉反应。结论 :试条法诊断恶性疟快速方便 ,能诊断早期恶性疟患者。     

艾博混合疟/恶性疟快速诊断试剂效果评价

目的 评价艾博混合疟/恶性疟(Malaria Pan./p.f..)快速诊断试剂的检测效果.方法 采集疟疾、疑似疟疾、不明原因发热及感冒“四热”患者血样,以显微镜镜检方法为金标准,比较艾博混合疟/恶性疟试剂检测效果结果 共采集584份血样,艾博试剂检测恶性疟原虫277份,灵敏度为98.9％,特异性为97.7％,与显微镜符合率为98.3％.艾博试剂检测混合疟377份的灵敏度为99.5％,特异性为99.0％,与显微镜符合率为99.3％,总符合率为98.8％,上述2方面的检测结果经Kappa一致性检验,Kappa值均大于0.97.结论 艾博混合疟/恶性疟试剂盒实验室检测敏感性和特异性高,能检测混合疟并区分恶性疟,结果与血涂片吉氏染色镜检结果高度一致,适用于疟疾流行的基层使用.     

双重免疫色谱技术检测恶性疟和间日疟的初步观察

用双重免疫色谱技术 ( ICT)对疟区门诊的“四热”病人进行疟疾检测 ,以镜检结果为对照 ,评价 ICT诊断疟疾的效果。检测 93例 ,敏感度和特异性恶性疟为 91.7%和 94.7% ,间日疟为 88.2 %和 10 0 % ,两者之间无交叉反应。显示双重 ICT检测疟疾快速简便 ,准确性高 ,且能区分虫种 ,具有广阔的应用前景     

国产试剂RDT诊断疟疾效果评价

目的将国产试剂疟疾快速诊断试验（RDT）检测结果与镜检结果及进口试剂RDT和PCR结果进行比较,评价国产试剂RDT诊断疟疾的效果。方法收集160例疟疾病人或疑似疟疾病人血样,分别采用两种RDT、镜检和PCR进行检测,对检测结果进行比较。结果160份血样采用国产、进口试剂RDT及镜检和PCR检测疟疾感染,阳性率分别为45．00％、47．50％、41．25％和42．50％,经配对资料的Х^2检验,差异无统计学意义（P〉0．05）;镜检和PCR法均检出2例卵形疟,而国产和进口试剂RDT均为阴性。以镜检为标准．到产试剂RDT检测间日疟和恶性疟的敏感度为94％,特异度87%,假阳性率13％,假阴性率6％,阳性预测值83％,阴性预测值95％;以PCR为标准,国产试剂RDT检测间日疟和恶性疟的敏感度为94％,特异度89％,假阳性率11％,假阴性率6％,阳性预测值83％,阴性预测值95％。国产试剂RDT与进口试剂RDT检测结果比较差异无统计学意义（Kappa=0．95,P〉0．05）。结论国产试剂RDT与进口试剂RDT检测结果高度一致,在基层可取代进口试剂RDT进行疟疾病例主动监测。     

Dipstick和PCR方法检测疟区门诊恶性疟的评价

目的 评价Ｄｉｐｓｔｉｃｋ和ＰＣＲ在疟区门诊诊断恶性疟的应用效果。方法 以厚血膜镜检结果作为对照，Ｄｉｐｓｔｉｃｋ采用Ｂ－Ｄ公司的ＰａｒａＳｉｇｈｔ－Ｆ试剂盒，ＰＣＲ采用直接扩增滤纸干血滴中疟原虫的方法。结果 共调查１１２例发热病人。Ｄｉｐｓｔｉｃｋ和ＰＣＲ的灵敏度分别为９３．５％和８３．９％，特异度分别为９５．１％和９８．８％。原虫密度越高，检出率越高（趋势Ｐ〈０．０１）。结论 Ｄｉｐｓｔｉｃｋ     

新型荧光光源吖啶橙染色和QBC技术快速诊断间日疟的现场评价

１９９２－１９９８年期间用新型荧光光源,薄血膜吖淀橙染色法和吖啶橙包被的毛细管法,分别在四川省筠连县和名山县疟疾流行区,对４２８人进行现场应用,其中１４５例采用ＡＯ法和ＱＢＣ技术同时检测,并用姬姆萨染色作对照。     

Efficiency and specificity of the KAT-test for rapid diagnosis of falciparum malaria

A new rapid KAT Quick Malaria test for the diagnosis of falciparum malaria, which is based on the detection of a monoclonal antibody-antigen complex of malaria parasites, has been worked out by the KAT Medical CC in South Africa. The efficiency and specificity of the KAT test were compared with those of the microscopic method and with the ICT test for rapid diagnosis of P. falciparum and P. vivax. The polymerase chain reaction was used as a control test. Testing for malaria was performed on 98 blood samples from feverish patients in Vietnam and Tadjikistan and among the persons who had returned to Moscow from endemic regions. The efficiency of the KAT test for falciparum-malaria was found to be 100% versus 90.5% with ICT. The absence of cross-reactions with P. vivax and the presence of pseudopositive results of the KAT test for fever cases of non-malaria origin indicate its high specificity. There was no correlation between the rate of test line colouring and the level of parasitemia. The KAT test yielded positive results only when gametocytes were found in blood specimens.     

Epidemiologic tools for malaria surveillance in an urban setting of low endemicity along the Colombian Pacific coast

An evaluation of 3 different methods for malaria diagnosis was carried out in an urban area of low endemicity on the Pacific coast of Colombia. Samples were collected from 833 symptomatic patients at a malaria clinic and examined by the polymerase chain reaction (PCR), quantitative buffy coat (QBC; Becton Dickinson, Franklin Lakes, NJ) method, and the traditional thick blood smear. The prevalence of Plasmodium falciparum malaria was 5.88% by thick blood smear, 7.34% by the QBC method, and 21.87% by PCR. The agreement between microscopists was 99.5%. The agreement between the QBC method and thick blood smear was 96.13% (n = 745). Samples positive by PCR but negative by thick blood smear or conversely negative by PCR and positive by thick blood smear were usually of low-level parasitemias. All 3 methods showed agreement in 76.3% of the samples. Sixty-nine (18.8%) samples were positive by PCR but negative by the other 2 methods. Ten samples were positive by both the QBC method and thick blood smear but negative by PCR; most of them had low-level parasitemias. The use of malaria diagnostic methods for epidemiologic surveillance is discussed.     

Field trial of the RTM dipstick method for the rapid diagnosis of malaria based on the detection of Plasmodium falciparum HRP-2 antigen in whole blood

The performance of the Quorum RapidTest Malaria (RTM) dipstick method that detects Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) antigen in whole blood was evaluated in a malaria endemic area. Results were compared with conventional Giemsa-stained blood films. Of 306 people tested 37.9% (116/306) were found to be parasitaemic; of these 66.4% (77/116) were P. vivax and 32.8% (38/116) were P. falciparum infections. There was only one (0.9%) mixed P. falciparum plus P. vivax infection.The RTM test was positive in 35/36 patients with P. falciparum identified on blood smear examination, resulting in a sensitivity of 97.2% [95% confidence interval (CI): 91.6-102.8%]. Specificity was 96.3% (95% CI: 93.9-98.6%).The RTM test had a positive predictive value of 77.8% (95% CI: 65.7-89.9%) and a negative predictive value of 99.6% (95% CI: 98.4-100.8%). Of the 10 false positives, seven reported recent malaria episode and treatment, indicating persistence of antigenaemia. If these were assumed truly infected, the positive predictive value is increased to 93.3% (95% CI: 85.8-100.8%).The RTM test was positive in all seven P. falciparum infections with gametocytes and one mixed infection, but was negative in all falciparum gametocytes and relapsing fever cases. All but one P. vivax infection gave negative result on the RTM test.The RTM test missed one patient with parasitaemia. The test is highly sensitive and specific requiring no instrument or trained personnel. It appears to be a very useful tool for rapid diagnosis of malaria, especially in the rural health institutions with limited diagnostic facilities.     

Diagnosis of imported malaria by Plasmodium lactate dehydrogenase (pLDH) and histidine-rich protein 2 (PfHRP-2)-based immunocapture assays.

This study was conducted to evaluate the performance of two rapid non-microscopic assays: Plasmodium lactate dehydrogenase (pLDH) assay (OptiMAL) and Plasmodium falciparum histidine-rich protein 2 (PfHRP-2) assay (ICT Malaria). The assays were used to detect malaria infection in 515 immigrants living in Kuwait. The performance of both assays was compared to that of microscopy of Giemsa-stained thick blood films and to each other. Of the 515 patients tested, 163 were positive for malaria parasites by microscopy of thick blood film. Of these, 87 were infected with Plasmodium vivax parasites, 63 with P. falciparum, 1 with Plasmodium malariae, and 12 had mixed infections of P. falciparum and P. vivax. The PfHRP-2 assay detected 53 P. falciparum infections and, as expected, failed to detect all but one case of P. vivax. Three cases of mixed infections were also not detected by this assay. The pLDH assay detected 56 P. falciparum cases and 77 P. vivax infections but failed to detect 4 cases of mixed infections. Compared to microscopy, the performance of both the assays to diagnose P. falciparum infection was comparable. The sensitivity for the PfHRP-2 assay was 82% with a specificity of 99.0% and for the pLDH assay the sensitivity was 89% with a specificity of 99.5%. The PfHRP-2 assay detected 4 false positive cases, 2 of which were also detected by the pLDH assay. These patients reported treatment with chloroquine in the last 2-5 weeks. Though the immunocapture diagnostic assays may be helpful in certain situations, microscopy of thick blood film is still the method of choice in diagnosing imported malaria.