Performance evaluation of a combination Plasmodium dual-antigen CRP rapid diagnostic test in Lambaréné, Gabon.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-08-23 DOI:10.1007/s15010-024-02366-y

Ayodele Alabi, Fungai P Musangomunei, Fabrice Lotola-Mougeni, Juste C Bie-Ondo, Kristin Murphy, Paulin N Essone, Anita L Kabwende, Saidou Mahmoudou, Aurélien Macé, Victoria Harris, Michael Ramharter, Martin P Grobusch, Maria Yazdanbakhsh, B Leticia Fernandez-Carballo, Camille Escadafal, Peter G Kremsner, Sabine Dittrich, Selidji T Agnandji

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Abstract

Purpose: The consequent use of malaria rapid diagnostic tests (RDTs) preceding a treatment decision has improved the global management of malaria. A combination RDT, including an inflammation marker to potentially guide antibiotic prescription, could improve the management of acute febrile illness (AFI).

Methods: We performed a prospective, cross-sectional study in Gabon evaluating the STANDARD Malaria/CRP DUO (S-DUO) RDT. Participants aged 2 to 17 years with fever at presentation and/or a history of fever < 7 days were enrolled. Expert microscopy, SD Bioline Malaria Ag P.f/Pan test for malaria detection, and NycoCard CRP device for CRP were used as comparators. AFI cases were classified on a spectrum encompassing bacterial vs. non-bacterial infection.

Results: 415 participants with AFI were enrolled. S-DUO RDT sensitivity and specificity for malaria detection vs. microscopy were 99·1% (95·2-100%) and 72·7% (64·3-80·1%); and for CRP detection (20 mg/L and above) 86·9% (80-92%) and 87% (79·2-92·7%), respectively. The difference in CRP levels between bacterial infection (mean = 41·2 mg/L) and other causes of fever, measured from our study population using the Nycocard device, was statistically significant (p < 0·01); CRP precision-recall AUC to distinguish bacterial infection class vs. non-bacterial classifications was 0·79.

Conclusion: S-DUO RDT is suitable for malaria detection in moderate-to-high malaria transmission settings such as in Lambaréné; however, a CRP band detection limit > 40 mg/L is more adequate for indication of antibiotic prescription for AFI cases in Gabon.

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加蓬兰巴雷内疟原虫双抗原 CRP 组合快速诊断检测的性能评估。

目的：在做出治疗决定前使用疟疾快速诊断检测（RDT）已改善了全球疟疾管理。包括炎症标志物在内的综合 RDT 有可能指导抗生素处方，从而改善急性发热性疾病（AFI）的管理：我们在加蓬开展了一项前瞻性横断面研究，对 STANDARD Malaria/CRP DUO（S-DUO）RDT 进行了评估。参与者年龄在 2 至 17 岁之间，发病时发烧和/或有发烧史：415 名患有 AFI 的患者入组。与显微镜检查相比，S-DUO RDT 检测疟疾的灵敏度和特异性分别为 99-1% (95-2-100%) 和 72-7% (64-3-80-1%)；检测 CRP（20 mg/L 及以上）的灵敏度和特异性分别为 86-9% (80-92%) 和 87% (79-2-92-7%)。使用 Nycocard 设备从我们的研究人群中测出的细菌感染（平均值 = 41-2 mg/L）与其他原因引起的发热之间的 CRP 水平差异具有统计学意义（p 结论：S-DUO RDT 是一种有效的发热检测方法：S-DUO RDT 适合在中度至高度疟疾传播环境（如兰巴雷内）中检测疟疾；然而，CRP 波段检测限 > 40 mg/L 更适合作为加蓬 AFI 病例的抗生素处方指示。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.