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Évaluation d’un test de diagnostic rapide et d’un microscope à fluorescence portable pour le diagnostic du paludisme à Cotonou (Bénin)

Assessment of a rapid diagnostic test and portable fluorescent microscopy for malaria diagnosis in Cotonou (Bénin)

  • Santé Publique / Public Health
  • Published:
Bulletin de la Société de pathologie exotique

Résumé

Le but du travail était d’étudier les performances d’un test de diagnostic rapide (TDR) du paludisme (SD Bioline Malaria Ag P.f/Pan®) et du microscope à fluorescence (CyScope®) par rapport à la goutte épaisse (GE) pour confirmer le diagnostic clinique de paludisme à Cotonou. L’enquête a été réalisée dans deux hôpitaux, de juin à octobre 2010, chez des personnes âgées de six mois à 70 ans. Tous les cas de fièvres suspectés de paludisme envoyés au laboratoire pour confirmation biologique ont fait l’objet d’une GE, d’un TDR et d’une lame pour le microscope à fluorescence portable. Tous les tests ont été réalisés et lus dans les laboratoires des hôpitaux impliqués, avec un contrôle de qualité des lames de GE au laboratoire de parasitologie du Centre hospitalier universitaire de Cotonou. Au total, 354 personnes avec fièvre indéterminée ont été incluses. La proportion des cas de paludisme parmi les cas cliniques est de: 22,8 % par la GE, 25,4 % par le TDR et 25,1 % avec le microscope à fluorescence portable. La sensibilité, la spécificité, les valeurs prédictives positives et négatives par rapport à la GE étaient, pour le TDR, 96,3, 95,6, 86,7, 98,9 %; pour le microscope à fluorescence portable, 97,5, 96,7, 89,8, 99,27 %. Avec ces performances, ces deux méthodes présentent des avantages certains pour l’aide au diagnostic de paludisme dans les structures périphériques de santé qui ne disposent pas des ressources nécessaires pour effectuer la confirmation du diagnostic par la GE.

Abstract

The aim of the study was to determine the accuracy of a rapid diagnostic test (SD Bioline Malaria Ag P.f/ Pan®) and fluorescent microscopy (CyScope®) in confirming presumptive malaria diagnosis in Cotonou. Thick blood smear was used as the reference technique for comparison. Testing was conducted on persons between the ages of 6 months and 70 years at two hospitals from June to October 2010. If malaria was suspected in the sample by the nurse based on clinical findings and sent to laboratory for confirmation, one thick smear, one rapid diagnostic test and one slide for the fluorescent microscopy were performed. All tests were read in hospital laboratories involved with the quality control of thick blood smear in the parasitology laboratory of National University Hospital of Cotonou. A total of 354 patients with clinical diagnosis of malaria were included. Malaria prevalence determined by thick smear, rapid diagnostic test and fluorescent microscopy was 22.8%, 25.4%, and 25.1% respectively. The sensitivity, specificity, positive and negative predictive values compared to the thick smears were 96.3, 95.6, 86.7, and 98.9% for rapid diagnostic test; and 97.5, 96.7, 89.8, and 99.27% for fluorescent microscopy. With these performances, these tests meet acceptability standards recommended by WHO for rapid tests (sensitivity > 95%). These two methods have advantages for the confirmation of malaria diagnosis in peripheral health structures that lack the resources to conduct diagnosis confirmation by the thick blood smear.

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Authors and Affiliations

  1. 06 BP 1372, Cotonou, Bénin

    A. Ogouyèmi-Hounto, D. Kinde-Gazard, C. Keke, E. Gonçalves, N. Alapini, F. Adjovi, L. Adisso, C. Bossou, Y. V. Denon & A. Massougbodji

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  1. A. Ogouyèmi-Hounto
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  2. D. Kinde-Gazard
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  3. C. Keke
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  4. E. Gonçalves
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  5. N. Alapini
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  7. L. Adisso
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  8. C. Bossou
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  9. Y. V. Denon
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  10. A. Massougbodji
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Correspondence to A. Ogouyèmi-Hounto.

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Ogouyèmi-Hounto, A., Kinde-Gazard, D., Keke, C. et al. Évaluation d’un test de diagnostic rapide et d’un microscope à fluorescence portable pour le diagnostic du paludisme à Cotonou (Bénin). Bull. Soc. Pathol. Exot. 106, 27–31 (2013). https://doi.org/10.1007/s13149-012-0264-7

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  • DOI: https://doi.org/10.1007/s13149-012-0264-7

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