摘要
目的评估疟疾传染源监测检验方法的诊断效率,探索监测工作中用快速诊断检测(RDT)作为常规检测手段的可能性。方法采集成都市2016年7月-2018年3月中国疾病预防控制信息系统报告的疑似、临床诊断、确诊的疟疾病人的血样。分别采用血涂片显微镜检查、RDT及聚合酶链反应(PCR)进行检测。RDT试剂分别采用国产(广东万孚)和进口(Binax Now)进行检测。结果共报告141例病例,确诊136例,均为输入性病例。镜检诊断效率为87.23%,PCR诊断效率为92.91%。进口RDT诊断效率为92.20%;对恶性疟的敏感度为98.85%,恶性疟以外疟疾的敏感度为79.59%。国产RDT诊断效率为95.74%,对恶性疟敏感度为97.72%,恶性疟以外疟疾的敏感度为95.92%。进口RDT分别与镜检及PCR结果比较差异有统计学意义(χ2=162.80,P<0.05;χ2=128.77,P<0.05)。诊断效率由高到低排位为:RDT、PCR、镜检。国产RDT与进口RDT检测结果比较差异有统计学意义(χ2=259.71,P<0.05),国产RDT对卵形疟更灵敏。结论 RDT具有较高的诊断效率,可作为常规监测手段。在消除后疟疾监测工作中,应广泛应用于基层。
Objective To evaluate the diagnostic efficiency of monitoring methods for infection sources in malaria,and explore the possibilities of using rapid diagnostic tests(RDT)as the conventional detection methods in monitoring work.Methods The blood samples were collected from the patients,who were suspected,clinically diagnosed and confirmed with malaria in Chengdu from July 2016 to March 2018 by the China Disease Prevention and Control Information System.Microscopic inspection of blood smear,RDT and polymerase chain reaction(PCR)were used for detection.RDT reagents used for the tests were the domestic Wanfu and the imported Binax Now.Results A total of 141 cases were reported,among which there were 136 imported confirmed cases.The diagnostic efficiency of microscopic inspection was 87.23%,while diagnostic efficiency of PCR was 92.91%.The diagnostic efficiency of imported RDT reagent was 92.20%;the sensitivity to falciparum malaria was 98.85%,and the sensitivity of malaria other than falciparum malaria was 79.59%.The diagnostic efficiency of domestic RDT reagents was 95.74%;the sensitivity to falciparum malaria was 97.72%,and the sensitivity of malaria other than falciparum malaria was 95.92%.The differences between imported RDT reagents and microscopic examination and PCR results were statistically significant(χ~2=162.80,P<0.05;χ~2=128.77,P<0.05).The diagnostic efficiency from high to low was:RDT,PCR,microscopic examination.The result of domestic RDT was compared with the imported product and the difference was statistically significant(χ~2=259.71,P<0.05).Domestic RDT reagents was more sensitive to ovale malaria.Conclusions RDT had high diagnostic efficiency and should be used as a routine monitoring tool.In the post-elimination malaria surveillance work,it should be widely used in the grassroots.
作者
汪乐媛
杨宇川
邹晏
宋志勇
陈刚
郁涛
WANG Le-yuan;YANG Yu-chuan;ZOU Yan;SONG Zhi-yong;CHEN Gang;YU Tao(Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041;Sichuan Center for Disease Control and Prevention,Chengdu,Sichuan 610041,China)
出处
《热带医学杂志》
CAS
2019年第7期853-855,885,共4页
Journal of Tropical Medicine
关键词
疟疾
传染源监测
检验方法
Malaria
Surveillance for infectious source
Detection methods
