Analysis of malaria detection capability of laboratories in the districts of Shanghai during 2017—2019

doi:10.12140/j.issn.1000-7423.2021.03.007

Abstract

Abstract:

Objective To recheck the blood samples of malaria cases sent by district-level centers for disease control and prevention (CDC), in Shanghai Municipal Center for Disease Control and Prevention (SCDC), and analyze the review results, in order to provide a basis for improving the malaria diagnostic capability of district CDCs.Methods Blood smears and whole blood samples submitted by the district CDC malaria laboratories were rechecked by SCDC using microscopic examination and nuclear acid detection (nested PCR) during 2017—2019. Using the examination by SCDC as the standard, the positive and negative coincidence rates of microscopic examination, and the sensitivity and specificity of malaria nucleic acid detection performed in district CDC malaria laboratories were analyzed. In 2019, blind assessment of malaria nucleic acid tests was conducted for all district CDCs of each district.Results A total of 232 malaria samples were submitted by district CDCs for rechecking in 2017—2019, among them 225 were complete samples (containing both blood smear and whole blood samples), with a completeness rate of 99.1% (225/227). Of the 225 complete samples, 99 samples were from Jinshan District (44.0%); 35 from Jing’an District (15.6%); 17 from Pudong New District (7.6%); 15 from Hongkou District (6.7%); Qingpu District and Chongming District submitted the least numbers of samples (0 and 1, respectively); while other districts provided less than 6.0% of the samples. The recheck of 225 complete samples showed an overall coincidence rate, positive coincidence rate and negative coincidence rate being 96.0% (216/225), 98.8% (170/172) and 86.8% (46/53), respectively, and the coincidence rate of nucleic acid detection 88.8% (103/116). The district CDCs used the quantitative real-time PCR (qPCR) method for nucleic acid detection, resulting in a sensitivity of 76.6% (85/111), which was significantly different from that of the nested PCR method used by SCDC (87.4%, 97/111) (P < 0.05). The specificity of the two nucleic acid detection methods was 100.0%. Comprehensive evaluation of the 225 samples by using the two detection methods showed that the coincidence rate of district CDCs was 96.9% (218/225), and the misjudgment rate was 3.1% (7/225), including 5 with qualitative errors and 2 with errors in species identification. In 2019, the overall correct detection rate of blind assessment of malaria nucleic acid by district CDCs was 97.5% (78/80). Specifically, the correct detection rate of P. falciparum sample was 94.1% (32/34), which was not significantly different from those of the other four types of samples (P. vivax, P.ovale, P. malariae and negative infection) (P > 0.05). Conclusion From 2017 to 2019, the malaria laboratories of district CDCs showed a strong capability of malaria microscopic examination, but the sensitivity of nuclear acid detection needs to be improved.

Key words: Malaria, Laboratory, Microscopic examination, Nucleic acid detection, Coincidence rate

CLC Number:

R531.3

ZHANG Yao-guang, JIANG Li, WANG Zhen-yu, ZHU Min, ZHU Qian, MA Xiao-jiang, WU Huan-yu. Analysis of malaria detection capability of laboratories in the districts of Shanghai during 2017—2019[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021, 39(3): 337-342.

Figures/Tables 4

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References 10

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引物名称 Primer name	引物序列（5′→3′） Primer sequence （5′→3′）
rPLU1	TCAAAGATTAAGCCATGCAAGTGA
rPLU5	CCTGTTGTTGCCTTAAACTTC
rFAL1	TTAAACTGGTTTGGGAAAACCAAATATATT
rFAL2	ACACAATGAACTCAATCATGACTACCCGTC
rVIV1	CGCTTCTAGCTTAATCCACATAACTGATAC
rVIV2	ACTTCCAAGCCGAAGCAAAGAAAGTCCTTA
rMAL1	ATAACATAGTTGTACGTTAAGAATAACCGC
rMAL2	AAAATTCCCATGCATAAAAAATTATACAAA
rOVA1	ATCTCTTTTGCTATTTTTTAGTATTGGAGA
rPLU2	ATCTAAGAATTTCACCTCTGACATCTG
rPLU3	TTTTTATAAGGATAACTACGGAAAAGCTGT
rPLU4	TACCCGTCATAGCCATGTTAGGCCAATACC

区 District	样品数 No. samples	阳性样品数No. positive samples					阴性样品数 No. negative samples
区 District	样品数 No. samples	恶性疟原虫 P. falciparum	间日疟原虫 P. vivax	卵形疟原虫 P. ovale	三日疟原虫 P. malariae	混合感染 Mixed infection	阴性样品数 No. negative samples
金山Jinshan	99	77	3	8	2	1	8
静安Jing’an	35	20	3	8	4	0	0
浦东Pudong	17	14	1	1	0	0	1
虹口Hongkou	15	13	0	1	0	0	1
闵行Minhang	13	8	0	4	1	0	0
黄浦Huangpu	12	10	0	1	1	0	0
徐汇Xuhui	9	5	0	0	1	0	3
奉贤Fengxian	5	4	0	0	0	0	1
普陀Putuo	4	4	0	0	0	0	0
宝山Baoshan	4	2	1	0	1	0	0
嘉定Jiading	3	1	0	2	0	0	0
长宁Changning	3	3	0	0	0	0	0
松江Songjiang	3	3	0	0	0	0	0
杨浦Yangpu	2	2	0	0	0	0	0
崇明Chongming	1	1	0	0	0	0	0
青浦Qingpu	0	0	0	0	0	0	0
合计Total	225	167	8	25	10	1	14

	镜检Microscopic examination			PCR			综合评价Synthetical evaluation
年份 Year	镜检检测数 No. microscopic detection	符合数 No.coincidence	符合率% Coincidence rate/%	PCR检测数 No. PCR detection	符合数 No.coincidence	符合率% Coincidence rate/%	总检测数 No.total detection	符合数 No. coincidence	符合率% Coincidence rate/%
2017	96	92	95.8	15	12	80.0	96	94	97.9
2018	63	61	96.8	44	40	90.9	63	62	98.4
2019	66	63	95.5	57	51	89.5	66	62	93.9
合计Total	225	216	96.0	116	103	88.8	225	218	96.9

虫种 Plasmodium	检测数 No. detected	正确数 No. qualified	正确率/% Qualified rate/%
恶性疟原虫 P. falciparum	34	32	94.1
间日疟原虫P. vivax	13	13	100
三日疟原虫 P. malariae	12	12	100
卵形疟原虫P. ovale	8	8	100
阴性Negative	13	13	100
合计Total	80	78	97.5

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