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在塞内加尔的Kédougou,三种基于LDH的疟疾快速诊断测试的性能和可用性评估
Babacar Souleymane Sambe1, Stephanie Zobrist2, William Sheahan2
1Institut Pasteur de Dakar, Dakar, Senegal.
medRxiv : the preprint server for health sciences
|December 23, 2024
概括
使用乳酸脱酶 (LDH) 的疟疾快速诊断测试 (RDTs) 是有前途的,其中一种结合HRP2和LDH的测试达到78%的灵敏度. 可以使用检测的分析极限来预测RDT性能.
科学领域:
- 疟疾学 疟疾学
- 传染性疾病 传染性疾病
- 诊断技术 诊断技术 诊断技术
背景情况:
- 缺少HRP2/3基因的Plasmodium falciparum寄生虫的出现影响了基于histidine丰富的蛋白2 (HRP2) 的疟疾快速诊断测试 (RDT) 的性能.
- 基于乳酸脱酶 (LDH) 的RDTs提供了一个潜在的替代方案,以解决目前基于HRP2的测试的局限性.
- 改善疟疾诊断对于有效的病例管理和疾病控制至关重要.
研究的目的:
- 评估三种基于乳酸脱酶 (LDH) 的疟疾快速诊断试验 (RDT) 的诊断性能和可用性.
- 评估与抗原度和检测分析极限有关的RTD性能.
- 确定HRP2和LDH目标在表现最佳的研发和开发技术中的贡献.
主要方法:
- 在塞内加尔的Kédougou进行了一项横截面诊断准确性研究.
- 除了显微镜和PCR,还评估了三种基于LDH的RDT.
- 使用定量多重测定测量抗原度,并对抗原水平和PCR结果分析RDT性能.
主要成果:
- 该Pf (pLDH/HRPII) RDT表现出最高的灵敏度 (78%) 和特异性 (89%),性能优于显微镜.
- 当与抗原度相比较时,所有评估的RDTs的表现都比PCR结果更好.
- RDT线的强度与抗原度相关,使用分析检测极限 (LOD) 的预测灵敏度与观察到的灵敏度保持一致.
结论:
- 性能最好的Plasmodium falciparum RDT利用了HRP2和LDH目标来提高灵敏度.
- 研发技术的分析LOD可以有效地预测其在已知抗原度的人群中的表现.
- 基于LDH的RDTs显示出可靠疟疾诊断的潜力,特别是在HRP2/3删除寄生虫的地区.
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