Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia
Abstract Background In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. We studied the performance of the highly sensitive-RDT...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03114-4 |
| _version_ | 1828475963318468608 |
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| author | A. M. Vásquez G. Vélez A. Medina E. Serra-Casas A. Campillo I. J. Gonzalez S. C. Murphy A. M. Seilie X. C. Ding A. Tobón Castaño |
| author_facet | A. M. Vásquez G. Vélez A. Medina E. Serra-Casas A. Campillo I. J. Gonzalez S. C. Murphy A. M. Seilie X. C. Ding A. Tobón Castaño |
| author_sort | A. M. Vásquez |
| collection | DOAJ |
| description | Abstract Background In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. We studied the performance of the highly sensitive-RDT (hsRDT) and the loop mediated isothermal DNA amplification (LAMP) for the detection of P. falciparum in pregnant women. Methods A cross-sectional study was conducted in two malaria-endemic municipalities in Colombia. We screened pregnant women in the context of an antenatal care program in health facilities and evaluated five tests (microscopy, conventional RDT, hsRDT, LAMP and nested polymerase chain reaction-PCR) for the detection of P. falciparum in peripheral blood, using a quantitative reverse transcription PCR (qRT-PCR) as the reference standard. Diagnostic performance of hsRDT and LAMP were compared with routine testing. Results The prevalence of P. falciparum was 4.5% by qRT-PCR, half of those infections were subpatent. The sensitivity of the hsRDT (64.1%) was slightly better compared to microscopy and cRDT (59 and 53.8% respectively). LAMP had the highest sensitivity (89.7%) for detecting P. falciparum and the ability to detect very low-density infections (minimum parasite density detected 0.08 p/μL). Conclusions There is an underestimation of Plasmodium spp. infections by tests routinely used in pregnant women attending antenatal care visits. LAMP methodology can be successfully implemented at local hospitals in malaria-endemic areas. The relevance of detecting and treating this sub-patent P. falciparum infections in pregnant women should be evaluated. Trial registration ClinicalTrials.gov, Identifier: NCT03172221 , Date of registration: May 29, 2017. |
| first_indexed | 2024-12-11T06:21:43Z |
| format | Article |
| id | doaj.art-00274aa9da804278bfa14e16fdcd3bef |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-11T06:21:43Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-00274aa9da804278bfa14e16fdcd3bef2022-12-22T01:17:48ZengBMCBMC Pregnancy and Childbirth1471-23932020-07-0120111110.1186/s12884-020-03114-4Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in ColombiaA. M. Vásquez0G. Vélez1A. Medina2E. Serra-Casas3A. Campillo4I. J. Gonzalez5S. C. Murphy6A. M. Seilie7X. C. Ding8A. Tobón Castaño9Grupo Malaria, Facultad de Medicina, Universidad de AntioquiaGrupo Malaria, Facultad de Medicina, Universidad de AntioquiaGrupo Malaria, Facultad de Medicina, Universidad de AntioquiaIndependent Consultant, FINDFINDFINDMalaria Molecular Diagnostic Laboratory, Departments of Laboratory Medicine and Microbiology and the Center for Emerging and Re-emerging Infectious DiseasesMalaria Molecular Diagnostic Laboratory, Departments of Laboratory Medicine and Microbiology and the Center for Emerging and Re-emerging Infectious DiseasesFINDGrupo Malaria, Facultad de Medicina, Universidad de AntioquiaAbstract Background In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. We studied the performance of the highly sensitive-RDT (hsRDT) and the loop mediated isothermal DNA amplification (LAMP) for the detection of P. falciparum in pregnant women. Methods A cross-sectional study was conducted in two malaria-endemic municipalities in Colombia. We screened pregnant women in the context of an antenatal care program in health facilities and evaluated five tests (microscopy, conventional RDT, hsRDT, LAMP and nested polymerase chain reaction-PCR) for the detection of P. falciparum in peripheral blood, using a quantitative reverse transcription PCR (qRT-PCR) as the reference standard. Diagnostic performance of hsRDT and LAMP were compared with routine testing. Results The prevalence of P. falciparum was 4.5% by qRT-PCR, half of those infections were subpatent. The sensitivity of the hsRDT (64.1%) was slightly better compared to microscopy and cRDT (59 and 53.8% respectively). LAMP had the highest sensitivity (89.7%) for detecting P. falciparum and the ability to detect very low-density infections (minimum parasite density detected 0.08 p/μL). Conclusions There is an underestimation of Plasmodium spp. infections by tests routinely used in pregnant women attending antenatal care visits. LAMP methodology can be successfully implemented at local hospitals in malaria-endemic areas. The relevance of detecting and treating this sub-patent P. falciparum infections in pregnant women should be evaluated. Trial registration ClinicalTrials.gov, Identifier: NCT03172221 , Date of registration: May 29, 2017.http://link.springer.com/article/10.1186/s12884-020-03114-4Malaria in pregnancyDiagnosticsRapid diagnostic testMicroscopyNucleic acid amplification techniquesLoop mediated isothermal DNA amplification (LAMP) |
| spellingShingle | A. M. Vásquez G. Vélez A. Medina E. Serra-Casas A. Campillo I. J. Gonzalez S. C. Murphy A. M. Seilie X. C. Ding A. Tobón Castaño Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia BMC Pregnancy and Childbirth Malaria in pregnancy Diagnostics Rapid diagnostic test Microscopy Nucleic acid amplification techniques Loop mediated isothermal DNA amplification (LAMP) |
| title | Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia |
| title_full | Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia |
| title_fullStr | Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia |
| title_full_unstemmed | Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia |
| title_short | Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia |
| title_sort | evaluation of highly sensitive diagnostic tools for the detection of p falciparum in pregnant women attending antenatal care visits in colombia |
| topic | Malaria in pregnancy Diagnostics Rapid diagnostic test Microscopy Nucleic acid amplification techniques Loop mediated isothermal DNA amplification (LAMP) |
| url | http://link.springer.com/article/10.1186/s12884-020-03114-4 |
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