Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women
Abstract Background While sub-microscopic malarial infections are frequent and potentially deleterious during pregnancy, routine molecular detection is still not feasible. This study aimed to assess the performance of a Histidine Rich Protein 2 (HRP2)-based ultrasensitive rapid diagnostic test (uRDT...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-05-01
|
| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03261-1 |
| _version_ | 1828850515734167552 |
|---|---|
| author | Valérie Briand Gilles Cottrell Nicaise Tuike Ndam Xavier Martiáñez-Vendrell Bertin Vianou Atika Mama Bienvenue Kouwaye Sandrine Houzé Justine Bailly Erasme Gbaguidi Darius Sossou Achille Massougbodji Manfred Accrombessi Alfredo Mayor Xavier C. Ding Nadine Fievet |
| author_facet | Valérie Briand Gilles Cottrell Nicaise Tuike Ndam Xavier Martiáñez-Vendrell Bertin Vianou Atika Mama Bienvenue Kouwaye Sandrine Houzé Justine Bailly Erasme Gbaguidi Darius Sossou Achille Massougbodji Manfred Accrombessi Alfredo Mayor Xavier C. Ding Nadine Fievet |
| author_sort | Valérie Briand |
| collection | DOAJ |
| description | Abstract Background While sub-microscopic malarial infections are frequent and potentially deleterious during pregnancy, routine molecular detection is still not feasible. This study aimed to assess the performance of a Histidine Rich Protein 2 (HRP2)-based ultrasensitive rapid diagnostic test (uRDT, Alere Malaria Ag Pf) for the detection of infections of low parasite density in pregnant women. Methods This was a retrospective study based on samples collected in Benin from 2014 to 2017. A total of 942 whole blood samples collected in 327 women in the 1st and 3rd trimesters and at delivery were tested by uRDT, conventional RDT (cRDT, SD BIOLINE Malaria Ag Pf), microscopy, quantitative polymerase chain-reaction (qPCR) and Luminex-based suspension array technology targeting P. falciparum HRP2. The performance of each RDT was evaluated using qPCR as reference standard. The association between infections detected by uRDT, but not by cRDT, with poor maternal and birth outcomes was assessed using multivariate regression models. Results The overall positivity rate detected by cRDT, uRDT, and qPCR was 11.6% (109/942), 16.2% (153/942) and 18.3% (172/942), respectively. Out of 172 qPCR-positive samples, 68 were uRDT-negative. uRDT had a significantly better sensitivity (60.5% [52.7–67.8]) than cRDT (44.2% [36.6–51.9]) and a marginally decreased specificity (93.6% [91.7–95.3] versus 95.7% [94.0–97.0]). The gain in sensitivity was particularly high (33%) and statistically significant in the 1st trimester. Only 28 (41%) out of the 68 samples which were qPCR-positive, but uRDT-negative had detectable but very low levels of HRP2 (191 ng/mL). Infections that were detected by uRDT but not by cRDT were associated with a 3.4-times (95%CI 1.29–9.19) increased risk of anaemia during pregnancy. Conclusions This study demonstrates the higher performance of uRDT, as compared to cRDTs, to detect low parasite density P. falciparum infections during pregnancy, particularly in the 1st trimester. uRDT allowed the detection of infections associated with maternal anaemia. |
| first_indexed | 2024-12-12T23:13:27Z |
| format | Article |
| id | doaj.art-0c6276525f5045f9ac12043b4ea1ed7d |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-12T23:13:27Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-0c6276525f5045f9ac12043b4ea1ed7d2022-12-22T00:08:31ZengBMCMalaria Journal1475-28752020-05-0119111210.1186/s12936-020-03261-1Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant womenValérie Briand0Gilles Cottrell1Nicaise Tuike Ndam2Xavier Martiáñez-Vendrell3Bertin Vianou4Atika Mama5Bienvenue Kouwaye6Sandrine Houzé7Justine Bailly8Erasme Gbaguidi9Darius Sossou10Achille Massougbodji11Manfred Accrombessi12Alfredo Mayor13Xavier C. Ding14Nadine Fievet15Institut de Recherche Pour le Développement (IRD), University of Bordeaux, InsermUniversité de ParisUniversité de ParisISGlobal, Hospital Clínic of Barcelona, Universitat de BarcelonaInstitut de Recherche Clinique du Bénin (IRCB)Institut de Recherche Clinique du Bénin (IRCB)Institut de Recherche Clinique du Bénin (IRCB)Université de ParisAP-HP, Centre National de Référence sur le paludisme, hôpital Bichat-Claude-BernardInstitut de Recherche Clinique du Bénin (IRCB)Institut de Recherche Clinique du Bénin (IRCB)Institut de Recherche Clinique du Bénin (IRCB)Institut de Recherche Clinique du Bénin (IRCB)ISGlobal, Hospital Clínic of Barcelona, Universitat de BarcelonaFINDUniversité de ParisAbstract Background While sub-microscopic malarial infections are frequent and potentially deleterious during pregnancy, routine molecular detection is still not feasible. This study aimed to assess the performance of a Histidine Rich Protein 2 (HRP2)-based ultrasensitive rapid diagnostic test (uRDT, Alere Malaria Ag Pf) for the detection of infections of low parasite density in pregnant women. Methods This was a retrospective study based on samples collected in Benin from 2014 to 2017. A total of 942 whole blood samples collected in 327 women in the 1st and 3rd trimesters and at delivery were tested by uRDT, conventional RDT (cRDT, SD BIOLINE Malaria Ag Pf), microscopy, quantitative polymerase chain-reaction (qPCR) and Luminex-based suspension array technology targeting P. falciparum HRP2. The performance of each RDT was evaluated using qPCR as reference standard. The association between infections detected by uRDT, but not by cRDT, with poor maternal and birth outcomes was assessed using multivariate regression models. Results The overall positivity rate detected by cRDT, uRDT, and qPCR was 11.6% (109/942), 16.2% (153/942) and 18.3% (172/942), respectively. Out of 172 qPCR-positive samples, 68 were uRDT-negative. uRDT had a significantly better sensitivity (60.5% [52.7–67.8]) than cRDT (44.2% [36.6–51.9]) and a marginally decreased specificity (93.6% [91.7–95.3] versus 95.7% [94.0–97.0]). The gain in sensitivity was particularly high (33%) and statistically significant in the 1st trimester. Only 28 (41%) out of the 68 samples which were qPCR-positive, but uRDT-negative had detectable but very low levels of HRP2 (191 ng/mL). Infections that were detected by uRDT but not by cRDT were associated with a 3.4-times (95%CI 1.29–9.19) increased risk of anaemia during pregnancy. Conclusions This study demonstrates the higher performance of uRDT, as compared to cRDTs, to detect low parasite density P. falciparum infections during pregnancy, particularly in the 1st trimester. uRDT allowed the detection of infections associated with maternal anaemia.http://link.springer.com/article/10.1186/s12936-020-03261-1MalariaPregnancyAfricaDiagnostic testsHRP-2 antigen |
| spellingShingle | Valérie Briand Gilles Cottrell Nicaise Tuike Ndam Xavier Martiáñez-Vendrell Bertin Vianou Atika Mama Bienvenue Kouwaye Sandrine Houzé Justine Bailly Erasme Gbaguidi Darius Sossou Achille Massougbodji Manfred Accrombessi Alfredo Mayor Xavier C. Ding Nadine Fievet Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women Malaria Journal Malaria Pregnancy Africa Diagnostic tests HRP-2 antigen |
| title | Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women |
| title_full | Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women |
| title_fullStr | Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women |
| title_full_unstemmed | Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women |
| title_short | Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women |
| title_sort | prevalence and clinical impact of malaria infections detected with a highly sensitive hrp2 rapid diagnostic test in beninese pregnant women |
| topic | Malaria Pregnancy Africa Diagnostic tests HRP-2 antigen |
| url | http://link.springer.com/article/10.1186/s12936-020-03261-1 |
| work_keys_str_mv | AT valeriebriand prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT gillescottrell prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT nicaisetuikendam prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT xaviermartianezvendrell prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT bertinvianou prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT atikamama prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT bienvenuekouwaye prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT sandrinehouze prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT justinebailly prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT erasmegbaguidi prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT dariussossou prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT achillemassougbodji prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT manfredaccrombessi prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT alfredomayor prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT xaviercding prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen AT nadinefievet prevalenceandclinicalimpactofmalariainfectionsdetectedwithahighlysensitivehrp2rapiddiagnostictestinbeninesepregnantwomen |