A comparative laboratory diagnosis of malaria：microscopy versus rapid diagnostic test kits

Azikiwe CCA; Ifezulike CC; Siminialayi IM; Amazu LU; Enye JC; Nwakwunite OE

摘要

Objective: To compare the two methods of rapid diagnostic tests (RDTs) and microscopy in the diagnosis of malaria. Methods: RDTs and microscopy were carried out to diagnose malaria. Percentage malaria parasitaemia was calculated on thin films and all non-acute cases of plasmodiasis with less than 0.001% malaria parasitaemia were regarded as negative. Results were simply presented as percentage positive of the total number of patients under study. The results of RDTs were compared to those of microscopy while those of RDTs based on antigen were compared to those of RDTs based on antibody. Patients' follow-up was made for all cases. Results:All the 200 patients under present study tested positive to RDTs based on malaria antibodies (serum) method (100%). 128 out of 200 tested positive to RDTs based on malaria antigen (whole blood) method (64%), while 118 out of 200 patients under present study tested positive to visual microscopy of Lieshman and diluted Giemsa (59%). All patients that tested positive to microscopy also tested positive to RDTs based on antigen. All patients on the second day of follow-up were non-febrile and had antimalaria drugs. Conclusions: We conclude based on the present study that the RDTs based on malaria antigen (whole blood) method is as specific as the traditional microscopy and even appears more sensitive than microscopy. The RDTs based on antibody (serum) method is unspecific thus it should not be encouraged. It is most likely that Africa being an endemic region, formation of certain levels of malaria antibody may not be uncommon. The present study also supports the opinion that a good number of febrile cases is not due to malaria. We support WHO’s report on cost effectiveness of RDTs but, recommend that only the antigen based method should possibly, be adopted in Africa and other malaria endemic regions of the world.

机译：目的：比较快速诊断检测和显微镜在疟疾诊断中的两种方法。方法：进行RDT和显微镜检查以诊断疟疾。在薄膜上计算疟疾寄生虫病百分率，所有非急性疟原虫病病例均小于0.001％疟疾寄生虫病被视为阴性。结果仅表示为所研究患者总数的阳性百分比。将RDT的结果与显微镜的结果进行比较，而将基于抗原的RDT的结果与基于抗体的RDT的结果进行比较。对所有病例进行了患者随访。结果：本研究中的所有200名患者均基于疟疾抗体（血清）方法对RDT呈阳性反应（100％）。根据疟疾抗原（全血）方法，在200例RDT中，有128例呈阳性（64％），而在本研究中，在200例患者中，有118例的Lieshman和稀释的吉姆萨肉眼呈阳性（59％）。所有显微镜检查呈阳性的患者也基于抗原对RDT呈阳性。随访第二天的所有患者均无发热，并已服用抗疟药。结论：我们根据本研究得出结论，基于疟疾抗原（全血）方法的RDT与传统显微镜一样特异性，甚至比显微镜更敏感。基于抗体（血清）方法的RDT是非特异性的，因此不应鼓励使用。非洲很可能是一个流行地区，形成一定水平的疟疾抗体可能并不少见。本研究还支持以下观点，即许多发热病例不是由于疟疾引起的。我们支持WHO关于RDT成本效益的报告，但建议在非洲和世界其他疟疾流行地区仅应采用基于抗原的方法。

A comparative laboratory diagnosis of malaria：microscopy versus rapid diagnostic test kits

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