Diagnostic Accuracy of a Thick Blood Smear Compared to qPCR for Malaria Associated with Pregnancy in Colombia

Tropical Medicine and Infectious Disease

article

Jaiberth Antonio Cardona-Arias¹  Luis Felipe Higuita Gutiérrez¹  Jaime Carmona-Fonseca³ 

[1] Escuela de Microbiología, Universidad de Antioquia;Facultad de Medicina, Universidad Cooperativa de Colombia;Grupo Salud y Comunidad César Uribe Piedrahíta, Facultad de Medicina, Universidad de Antioquia

关键词: gestation;    placenta;    congenital;    malaria;    thick blood smear;    qPCR;    diagnostic accuracy;   

DOI  :  10.3390/tropicalmed8020119

学科分类：社会科学、人文和艺术（综合）

来源: mdpi

【 摘 要 】

This study aimed to evaluate the accuracy of the thick blood smear (TBS) versus quantitative polymerase chain reaction (qPCR) for the diagnosis of malaria associated with pregnancy (MAP) caused by P. falciparum or P. vivax in Colombia in its gestational malaria (GM), placental malaria (PM), and congenital malaria (CM) forms as well as to compare its accuracy in different subgroups of pregnant women according to the presence of fever, anemia and a history of malaria. This was a diagnostic evaluation of 829 pregnant women, 579 placentas, 381 umbilical cord samples, and 221 neonatal peripheral blood samples. Accuracy was evaluated based on the parameters of sensitivity, specificity, predictive values, likelihood ratios, and validity index, with their 95% confidence intervals. The frequency of GM was 36% (n = 297/829), PM 27% (n = 159/579), and CM 16.5% (n = 63/381) in umbilical cord samples and 2% (n = 5/221) in neonatal peripheral blood samples. For GM, the sensitivity was 55%, with higher rates in those infected with P. vivax0.80 in all subgroups. No false positives were recorded in any of the subgroups. The TBS did not detect any cases of CM. This study found the TBS yielded satisfactory results in terms of diagnosing GM for P. vivax, pregnant women with previous malaria and febrile. It also showed that the TBS is not useful for diagnosing PM and CM. It is necessary to conduct surveillance of MAP with molecular methods in in groups where TBS is deficient (asymptomatic GM, P. falciparum, and pregnant women without history of malaria) to optimize the timely treatment of PM and CM, avoid the deleterious effects of MAP and achieve the malaria elimination goals in Colombia.

【 授权许可】

CC BY