斐济伤寒快速诊断测试和发热性疾病爆发评估,American Journal of Tropical Medicine and Hygiene

当前位置： X-MOL 学术 › American Journal of Tropical Medicine and Hygiene › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

斐济伤寒快速诊断测试和发热性疾病爆发评估
American Journal of Tropical Medicine and Hygiene Pub Date : 2021-11-29 , DOI: 10.4269/ajtmh.21-0771
Aneley Getahun Strobel _{1,

2} , Stephanie Airs ₃ , Cattram Nguyen _{4,

5} , Taina Rokobuli Vadei ₆ , Silivia Matanitobua ₆ , Mike Kama ₆ , Conall H Watson _{7,

8} , John A Crump ₉ , Edward Kim Mulholland _{5,

7} , Richard A Strugnell ₂ , Christopher M Parry _{3,

8,

10}

Affiliation

School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia.
School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki, Japan.
Murdoch Children's Research Institute, Melbourne, Australia.
Department of Pediatrics, University of Melbourne, Melbourne, Australia.
Fiji Ministry of Health and Medical Services, Suva, Fiji.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.
Centre for International Health, University of Otago, Dunedin, New Zealand.
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

摘要。伤寒是斐济的一种地方病，自 2000 年代初以来病例数有所增加，并有报告频繁爆发。我们评估了目前可用的伤寒快速诊断测试 (RDT)（TUBEX、Typhidot Rapid 和 Test-It 检测）的诊断准确性，以确定其在斐济针对血培养的性能，并检查其对伤寒爆发快速识别的适用性。RDT 的性能根据制造商的说明在斐济苏瓦的公共卫生参考实验室进行了评估。通过模拟来检验 RDT 将发热性疾病爆发归因于伤寒的潜在用途。诊断评估纳入了 179 名患者；49 人患有经血培养证实的伤寒，76 人因非伤寒病因而发烧，54 人是年龄匹配的社区对照。中位年龄（四分位距）为 29（20-46）岁。参与者中，92 名（51.4%）为男性，131 名（73.2%）为斐济土著人。TUBEX 检测的灵敏度为 77.6%，Typhidot Rapid 检测的灵敏度为 75.5%，Test-It 检测的灵敏度为 57.1%。Test-It 检测的特异性最高，为 93.4%，其次是 Typhidot Rapid 85.5% 和 TUBEX 60.5%。Typhidot Rapid 在将发热性疾病爆发归因于伤寒的模拟中表现最佳。由于敏感性低且特异性不同，伤寒 RDT 对于个体患者的诊断效果不佳。我们证明 RDT 在快速将发热性疾病暴发归因于伤寒方面很有用。Typhidot Rapid 具有灵敏度、特异性、阳性和阴性预测值、成本和易用性的最佳组合。

"点击查看英文标题和摘要"

Assessment of Rapid Diagnostic Tests for Typhoid Diagnosis and Assessment of Febrile Illness Outbreaks in Fiji

ABSTRACT. Typhoid is an endemic in Fiji with increases observed since the early 2000s and frequent outbreaks reported. We assessed the diagnostic accuracy of currently available typhoid rapid diagnostic tests (RDTs) (TUBEX, Typhidot Rapid, and Test-It assay) to establish their performance against blood culture in Fiji and to examine their suitability for rapid typhoid outbreak identification. The performance of RDTs was assessed in the public health reference laboratory in Suva, Fiji, according to the manufacturers’ instructions. A simulation was used to examine the potential use of RDTs for attribution of a febrile illness outbreak to typhoid. For the diagnostic evaluation, 179 patients were included; 49 had blood culture–confirmed typhoid, 76 had fever as a result of non-typhoid etiologies, and 54 were age-matched community controls. The median (interquartile range) age was 29 (20–46) years. Of the participants, 92 (51.4%) were male and 131 (73.2%) were indigenous Fijians. The sensitivities of the tests were 77.6% for TUBEX, 75.5% for Typhidot Rapid, and 57.1% for Test-It assay. The Test-It assay had the highest specificity of 93.4%, followed by Typhidot Rapid 85.5% and TUBEX 60.5%. Typhidot Rapid had the best performance in the simulation for attribution of a febrile illness outbreak to typhoid. Typhoid RDTs performed suboptimally for individual patient diagnosis due to low sensitivity and variable specificity. We demonstrate that RDTs could be useful in the field for rapid attribution of febrile illness outbreaks to typhoid. Typhidot Rapid had the best combination of sensitivity, specificity, positive and negative predictive values, cost, and ease of use for this purpose.

更新日期：2021-11-29

点击分享查看原文

点击收藏

公开下载

阅读更多本刊最新论文

全部期刊列表>>