背景:怀孕期间的疟疾仍然是全球主要的公共卫生问题,尤其是在撒哈拉以南非洲。在疟疾流行地区,大多数孕妇仍然无症状,但是疟疾仍然可能对母亲和她的后代造成并发症;以及作为传播感染的水库。尽管有这些影响,在埃塞俄比亚,没有注意使用高度敏感和特异性的实验室诊断工具诊断无症状的疟原虫感染(API).因此,这项研究的目的是比较快速诊断测试(RDT)的性能,显微镜和实时聚合酶链反应(RT-PCR)检测孕妇的API。
方法:一项基于医疗机构的横断面研究是在Fendeka镇医疗机构Jawi区接受产前护理的孕妇中进行的,埃塞俄比亚西北部从2月到3月,2019.共有166名参与者通过使用方便的抽样技术进行登记。使用半结构化问卷收集社会人口统计特征。收集干血斑(DBS)样品用于分子分析。使用RDT诊断孕妇无症状疟原虫感染,显微镜和RT-PCR。使用描述性统计来确定API的患病率。进行了方法比较,和Cohen的kappa系数(k)用于确定诊断方法之间的一致程度。还计算了寄生虫密度。
结果:API的患病率为9.6%,使用RDT的11.4%和18.7%,显微镜和RT-PCR,分别。原料药总体比例为19.3%。与显微镜相比,RDT的灵敏度为83.3%。快速诊断测试和显微镜检查也显示了50%和60%的灵敏度,分别,与RT-PCR相比。恶性疟原虫的平均寄生虫密度为3213寄生虫/μl,间日疟原虫的平均寄生虫密度为1140寄生虫/μl血液。
结论:研究区域的API患病率很高。与RT-PCR相比,RDT和显微镜检查的灵敏度均较低。因此,应重视孕妇API的常规实验室诊断,并使用更敏感和特异性的实验室诊断工具进行诊断。
BACKGROUND: Malaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women.
METHODS: A health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen\'s kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated.
RESULTS: The prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax.
CONCLUSIONS: Prevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools.