Evaluation of a non-isotopic polymerase chain reaction-based assay to detect and predict treatment failure of Plasmodium vivax malaria in travellers

被引:17
作者
Humar, A
Harrington, MA
Kain, KC
机构
[1] TORONTO GEN HOSP,TROP DIS UNIT,EN G224,DIV INFECT DIS,DEPT MED,TORONTO,ON M5G 2C4,CANADA
[2] UNIV TORONTO,TORONTO,ON,CANADA
基金
英国医学研究理事会;
关键词
malaria; Plasmodium vivax; polymerase chain reaction; treatment failure;
D O I
10.1016/S0035-9203(97)90258-3
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
With the emergence of chloroquine-resistant Plasmodium vivax (CRPV), new tests to detect P. vivax and predict response to therapy would be useful for clinical and research applications. We performed a 'blinded' evaluation of a non-isotopic (colourimetric) polymerase chain reaction (PCR) based assay (Digene SHARP Signal(TM) System) compared with microscopy and PCR/radiometric probe hydrization of ribosomal ribonucleic acid genes (RPH) for the detection of P. vivax malaria in 182 febrile travellers. Compared with PCR/RPH as the reference standard, the colourimetric assay had a sensitivity of 100% and specificity of 98%. Using microscopy as the reference standard, 84 of 87 patients with P. vivax infection had a positive colourimetric assay. The 3 patients with a negative assay were subsequently shown to be infected with P. ovale as determined by PCR/RPH. In a subset of patients followed longitudinally, the colourimetric assay was positive in 5 of 13 patients 6 or more days after initiation of therapy. Of these 5 patients, 4 were subsequently demonstrated to be infected with CRPV as determined by treatment failure in vivo and/or chloroquine blood levels. A positive assay result 6 or more days after initiation of therapy was associated with subsequent treatment failure (P<0.01). This non-isotopic assay is a sensitive, specific, and rapid method for the detection of P. vivax PCR products and may prove useful in predicting treatment failure.
引用
收藏
页码:406 / 409
页数:4
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