3种疟疾检测方法的应用分析
发布时间：2018-08-16 08:10
【摘要】：目的分析疟原虫镜检、抗原检测(快速诊断试验,RDT)和核酸检测(PCR)3种方法在疟疾病例检测应用中的效果。方法对2012-2015年上海市送检的疟疾病例和疑似疟疾病例血样的检测结果进行回顾性分析,以确诊病例为金标准,比较镜检、RDT和PCR等3种方法的诊断指标、虫种特异性鉴定能力和成本效益。不同检测方法的两两比较用χ2检验。结果 3种方法平行分析血样212份,结果显示,综合判定为阳性的167份,占78.8%,阴性45份,占21.2%。阳性血样中,120份为恶性疟原虫(Plasmodium falciparum)感染,占71.9%;22份为间日疟原虫(P.vivax)感染,占13.2%;17份为卵形疟原虫(P.ovale)感染,占10.2%;6份为三日疟原虫(P.malariae)感染,占3.6%;2份为混合感染,占1.2%。3种检测方法的诊断效率以PCR最高,为96.2%(204/212),RDT次之,为93.2%(192/206),镜检最低,为88.2%(187/212);镜检与RDT和PCR比较,差异具有统计学意义(P0.05);RDT与PCR比较,差异无统计学意义(P0.05)。与确诊病例比较,3种方法的总符合率以PCR最高,为95.3%(202/212),RDT次之,为93.2%(192/206),镜检最低,为88.2%(187/212);镜检与PCR比较,差异有统计学意义(P0.05)。对非恶性疟原虫的3种疟原虫的种特异性鉴定能力,以PCR最高,为95.6%(43/45),镜检次之,为91.1%(41/45),RDT最低,为68.9%(31/45);PCR与RDT比较,差异有统计学意义(P0.05);PCR与镜检比较,差异无统计学意义(P0.05)。对恶性疟原虫单一虫种的鉴定能力,以RDT最优,为100%(116/116);PCR次之,为93.3%(112/120);镜检最低,为84.2%(101/120)。根据是否纳入诊断标准、对仪器设备和技术的要求、诊断效能、检测的成本耗时、应用培训以及技术推广等14项指标综合评测显示,RDT得分为37分(满分42分),成本效益最高,镜检和PCR得分分别为26和27分。结论在以输入性恶性疟为主的疫情形势下,3种检测方法比较,检测效果以PCR和RDT较高,种特异性鉴定能力以PCR和镜检较好,成本效益以RDT最佳。
[Abstract]:Objective to analyze the effect of three methods of Plasmodium falciparum microscopic examination, rapid diagnostic test (PCR) and nucleic acid detection (PCR) in the detection of malaria cases. Methods the results of blood samples of malaria and suspected malaria cases from 2012 to 2015 in Shanghai were analyzed retrospectively. The diagnostic indexes of the three methods were compared using confirmed cases as gold standard. Ability and cost benefit of specific identification of insect species. 蠂 2 test was used to compare different detection methods. Results 212 blood samples were analyzed in parallel by three methods. The results showed that 167 samples were positive, accounting for 78.8%, and 45 samples were negative, accounting for 21.22%. Of the positive blood samples, 120 were infected with Plasmodium falciparum (Plasmodium falciparum), 22 were infected with Plasmodium vivax (P.vivax), 17 were infected with Plasmodium ovum (P.ovale), 6 were infected with Plasmodium falciparum (P.malariae), and 2 were mixed infection. The diagnostic efficiency of 1.2.3 methods was the highest (96.2% (204 / 212), 93.2% (1922 / 206), 88.2% (1872 / 212), respectively), and the difference was statistically significant (P0.05) compared with RDT and PCR (P0.05). Compared with the confirmed cases, the total coincidence rate of the three methods was the highest (95.3% (2023 / 212), 93.2% (1922 / 206) and 88.2% (1872 / 212), respectively. There was significant difference between PCR and PCR (P0.05). PCR was the highest (95.6%) (43 / 45), followed by microscopic examination (91.1% (41 / 45), the lowest was 68.9% (31 / 45) compared with RDT, the difference was statistically significant (P0.05) compared with microscopic examination (P0.05). The identification ability of single species of Plasmodium falciparum was 100% (116 / 116), followed by 93. 3% (112 / 120) and 84.2% (101 / 120) respectively. According to whether the diagnostic criteria are included, the requirements for instrument, equipment and technology, the diagnostic effectiveness, the cost and time consuming of testing, the comprehensive evaluation of 14 indicators, such as application training and technical popularization, shows that the RDT score is 37 (a full score of 42), and the cost benefit is the highest. Microscopic examination and PCR scores were 26 and 27, respectively. Conclusion under the situation of imported falciparum malaria, the results of three detection methods are higher in PCR and RDT, better in specific identification ability in PCR and microscopic examination, and the best in cost benefit in RDT.
【作者单位】： 上海市疾病预防控制中心上海市预防医学研究院;
【分类号】：R531.3
本文编号：2185408
[Abstract]:Objective to analyze the effect of three methods of Plasmodium falciparum microscopic examination, rapid diagnostic test (PCR) and nucleic acid detection (PCR) in the detection of malaria cases. Methods the results of blood samples of malaria and suspected malaria cases from 2012 to 2015 in Shanghai were analyzed retrospectively. The diagnostic indexes of the three methods were compared using confirmed cases as gold standard. Ability and cost benefit of specific identification of insect species. 蠂 2 test was used to compare different detection methods. Results 212 blood samples were analyzed in parallel by three methods. The results showed that 167 samples were positive, accounting for 78.8%, and 45 samples were negative, accounting for 21.22%. Of the positive blood samples, 120 were infected with Plasmodium falciparum (Plasmodium falciparum), 22 were infected with Plasmodium vivax (P.vivax), 17 were infected with Plasmodium ovum (P.ovale), 6 were infected with Plasmodium falciparum (P.malariae), and 2 were mixed infection. The diagnostic efficiency of 1.2.3 methods was the highest (96.2% (204 / 212), 93.2% (1922 / 206), 88.2% (1872 / 212), respectively), and the difference was statistically significant (P0.05) compared with RDT and PCR (P0.05). Compared with the confirmed cases, the total coincidence rate of the three methods was the highest (95.3% (2023 / 212), 93.2% (1922 / 206) and 88.2% (1872 / 212), respectively. There was significant difference between PCR and PCR (P0.05). PCR was the highest (95.6%) (43 / 45), followed by microscopic examination (91.1% (41 / 45), the lowest was 68.9% (31 / 45) compared with RDT, the difference was statistically significant (P0.05) compared with microscopic examination (P0.05). The identification ability of single species of Plasmodium falciparum was 100% (116 / 116), followed by 93. 3% (112 / 120) and 84.2% (101 / 120) respectively. According to whether the diagnostic criteria are included, the requirements for instrument, equipment and technology, the diagnostic effectiveness, the cost and time consuming of testing, the comprehensive evaluation of 14 indicators, such as application training and technical popularization, shows that the RDT score is 37 (a full score of 42), and the cost benefit is the highest. Microscopic examination and PCR scores were 26 and 27, respectively. Conclusion under the situation of imported falciparum malaria, the results of three detection methods are higher in PCR and RDT, better in specific identification ability in PCR and microscopic examination, and the best in cost benefit in RDT.
【作者单位】： 上海市疾病预防控制中心上海市预防医学研究院;
【分类号】：R531.3
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