ABSTRACT

The co-reactivity of the Plasmodium histidine-rich protein 2 (HRP2) and lactate dehydrogenase (pLDH) in malaria rapid diagnosis tests (mRDTs) as a potential indicator of high parasitemia linked to Plasmodium falciparum was evaluated in the reported study from Cameroon. The samples were screened for malaria using both mRDTs (SD bioline HRP2/pLDH), light microscopy and further confirmed by Plasmodium species-specific PCR assay. Of the 483 patients enrolled, 161 (33.3%) showed a reactive mRDTs amongst which 70 patients were positive by both microscopy and mRDTs with 30.0% (21/70) positive for HRP2 alone, while 70.0% (49/70) showed a dual reaction to HRP2 and pLDH parasite antigens. P. falciparum parasitemia was found to be significantly high among patients with both reactive antigens, (p < 0.0001) suggesting that mRDTs reactivity is influenced by parasite load which could be used as a diagnostic marker for therapeutic management of patients with high parasitemia in field conditions.

摘要

来自喀麦隆的报告研究评估了疟原虫富含组氨酸蛋白 2 (HRP2) 和乳酸脱氢酶 (pLDH) 在疟疾快速诊断测试 (mRDTs) 中的共同反应性，作为与恶性疟原虫相关的高寄生虫血症的潜在指标。使用 mRDT (SD bioline HRP2/pLDH)、光学显微镜对样本进行疟疾筛查，并通过疟原虫物种特异性 PCR 测定进一步确认。在入组的 483 名患者中，161 名 (33.3%) 显示 mRDT 反应性，其中 70 名患者通过显微镜检查和 mRDT 均呈阳性，其中 30.0% (21/70) 仅对 HRP2 阳性，而 70.0% (49/70) 显示双重对 HRP2 和 pLDH 寄生虫抗原的反应。恶性疟原虫发现具有两种反应性抗原的患者的寄生虫血症显着升高（p < 0.0001），表明 mRDT 的反应性受寄生虫负荷的影响，这可用作在野外条件下对高寄生虫血症患者进行治疗管理的诊断标志物。