The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard
The accuracy of techniques for the diagnosis of malaria are usually compared with optical microscopy, which is considered to be a gold standard. However, microscopy is prone to error and therefore makes it difficult to assess the reliability of other diagnostic techniques. We did a systematic review...
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| Veröffentlicht in: | The Lancet infectious diseases 2006-09, Vol.6 (9), p.582-588 |
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| creator | Ochola, LB Vounatsou, P Smith, T Mabaso, MLH Newton, CRJC |
| description | The accuracy of techniques for the diagnosis of malaria are usually compared with optical microscopy, which is considered to be a gold standard. However, microscopy is prone to error and therefore makes it difficult to assess the reliability of other diagnostic techniques. We did a systematic review to assess the specificity and sensitivity of diagnostic techniques in different settings, using a statistical method that avoided defining a gold standard. Performance varied depending on species of the malaria parasite, level of parasitaemia, and immunity. Overall, histidine-rich protein 2 (HRP2)-based dipsticks showed a high sensitivity (92·7%) and specificity (99·2%) for
Plasmodium falciparum in endemic areas. The acridine orange test was more sensitive (97·1%) in detecting
P falciparum in epidemiological studies, with a specificity of 97·9%. In the absence of a gold standard, HRP2 dipsticks and acridine orange could provide an alternative for detecting falciparum infections in endemic areas and epidemiological studies, respectively. Microscopy still remains more reliable in detecting non-falciparum infections. |
| doi_str_mv | 10.1016/S1473-3099(06)70579-5 |
| format | Article |
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Plasmodium falciparum in endemic areas. The acridine orange test was more sensitive (97·1%) in detecting
P falciparum in epidemiological studies, with a specificity of 97·9%. In the absence of a gold standard, HRP2 dipsticks and acridine orange could provide an alternative for detecting falciparum infections in endemic areas and epidemiological studies, respectively. Microscopy still remains more reliable in detecting non-falciparum infections.</description><identifier>ISSN: 1473-3099</identifier><identifier>EISSN: 1474-4457</identifier><identifier>DOI: 10.1016/S1473-3099(06)70579-5</identifier><identifier>PMID: 16931409</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Animals ; Biological and medical sciences ; Human protozoal diseases ; Humans ; Infectious diseases ; Light microscopy ; Malaria ; Malaria - diagnosis ; Malaria - therapy ; Medical sciences ; Microscopy - standards ; Parasites ; Parasitic diseases ; Patient Selection ; Plasmodium - isolation & purification ; Protozoal diseases ; Reproducibility of Results ; Sensitivity and Specificity ; Statistical methods ; Vector-borne diseases</subject><ispartof>The Lancet infectious diseases, 2006-09, Vol.6 (9), p.582-588</ispartof><rights>2006 Elsevier Ltd</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Limited Sep 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c486t-1a5b04fe2009acee6fa4eff80dfe766b49d2d8c3effdb3bbd7acd9e3aa1824de3</citedby><cites>FETCH-LOGICAL-c486t-1a5b04fe2009acee6fa4eff80dfe766b49d2d8c3effdb3bbd7acd9e3aa1824de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1473309906705795$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18029679$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16931409$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ochola, LB</creatorcontrib><creatorcontrib>Vounatsou, P</creatorcontrib><creatorcontrib>Smith, T</creatorcontrib><creatorcontrib>Mabaso, MLH</creatorcontrib><creatorcontrib>Newton, CRJC</creatorcontrib><title>The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard</title><title>The Lancet infectious diseases</title><addtitle>Lancet Infect Dis</addtitle><description>The accuracy of techniques for the diagnosis of malaria are usually compared with optical microscopy, which is considered to be a gold standard. However, microscopy is prone to error and therefore makes it difficult to assess the reliability of other diagnostic techniques. We did a systematic review to assess the specificity and sensitivity of diagnostic techniques in different settings, using a statistical method that avoided defining a gold standard. Performance varied depending on species of the malaria parasite, level of parasitaemia, and immunity. Overall, histidine-rich protein 2 (HRP2)-based dipsticks showed a high sensitivity (92·7%) and specificity (99·2%) for
Plasmodium falciparum in endemic areas. The acridine orange test was more sensitive (97·1%) in detecting
P falciparum in epidemiological studies, with a specificity of 97·9%. In the absence of a gold standard, HRP2 dipsticks and acridine orange could provide an alternative for detecting falciparum infections in endemic areas and epidemiological studies, respectively. 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Plasmodium falciparum in endemic areas. The acridine orange test was more sensitive (97·1%) in detecting
P falciparum in epidemiological studies, with a specificity of 97·9%. In the absence of a gold standard, HRP2 dipsticks and acridine orange could provide an alternative for detecting falciparum infections in endemic areas and epidemiological studies, respectively. Microscopy still remains more reliable in detecting non-falciparum infections.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>16931409</pmid><doi>10.1016/S1473-3099(06)70579-5</doi><tpages>7</tpages></addata></record> |
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| subjects | Animals Biological and medical sciences Human protozoal diseases Humans Infectious diseases Light microscopy Malaria Malaria - diagnosis Malaria - therapy Medical sciences Microscopy - standards Parasites Parasitic diseases Patient Selection Plasmodium - isolation & purification Protozoal diseases Reproducibility of Results Sensitivity and Specificity Statistical methods Vector-borne diseases |
| title | The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard |
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