Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana
Abstract Background This study seeks to compare the performance of HRP2 (First Response) and pLDH/HRP2 (Combo) RDTs for falciparum malaria against microscopy and PCR in acutely ill febrile children at presentation and follow-up. Methods This is an interventional study that recruited children < 5 ...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-12-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-018-2613-x |
| _version_ | 1818156016754229248 |
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| author | Isabella A. Quakyi George O. Adjei David J. Sullivan Amos Laar Judith K. Stephens Richmond Owusu Peter Winch Kwame S. Sakyi Nathaniel Coleman Francis D. Krampa Edward Essuman Vivian N. A. Aubyn Isaac A. Boateng Bernard B. Borteih Linda Vanotoo Juliet Tuakli Ebenezer Addison Constance Bart-Plange Felix Sorvor Andrew A. Adjei |
| author_facet | Isabella A. Quakyi George O. Adjei David J. Sullivan Amos Laar Judith K. Stephens Richmond Owusu Peter Winch Kwame S. Sakyi Nathaniel Coleman Francis D. Krampa Edward Essuman Vivian N. A. Aubyn Isaac A. Boateng Bernard B. Borteih Linda Vanotoo Juliet Tuakli Ebenezer Addison Constance Bart-Plange Felix Sorvor Andrew A. Adjei |
| author_sort | Isabella A. Quakyi |
| collection | DOAJ |
| description | Abstract Background This study seeks to compare the performance of HRP2 (First Response) and pLDH/HRP2 (Combo) RDTs for falciparum malaria against microscopy and PCR in acutely ill febrile children at presentation and follow-up. Methods This is an interventional study that recruited children < 5 years who reported to health facilities with a history of fever within the past 72 h or a documented axillary temperature of 37.5 °C. Using a longitudinal approach, recruitment and follow-up of participants was done between January and May 2012. Based on results of HRP2-RDT screening, the children were grouped into one of the following three categories: (1) tested positive for malaria using RDT and received anti-malarial treatment (group 1, n = 85); (2) tested negative for malaria using RDT and were given anti-malarial treatment by the admitting physician (group 2, n = 74); or, (3) tested negative for malaria using RDT and did not receive any anti-malarial treatment (group 3, n = 101). Independent microscopy, PCR and Combo-RDT tests were done for each sample on day 0 and all follow-up days. Results Mean age of the study participants was 22 months and females accounted for nearly 50%. At the time of diagnosis, the mean body temperature was 37.9 °C (range 35–40.1 °C). Microscopic parasite density ranged between 300 and 99,500 parasites/µL. With microscopy as gold standard, the sensitivity of HRP2 and Combo-RDTs were 95.1 and 96.3%, respectively. The sensitivities, specificities and predictive values for RDTs were relatively higher in microscopy-defined malaria cases than in PCR positive-defined cases. On day 0, participants who initially tested negative for HRP2 were positive by microscopy (n = 2), Combo (n = 1) and PCR (n = 17). On days 1 and 2, five of the children in this group (initially HRP2-negative) tested positive by PCR alone. On day 28, four patients who were originally HRP2-negative tested positive for microscopy (n = 2), Combo (n = 2) and PCR (n = 4). Conclusion The HRP2/pLDH RDTs showed comparable diagnostic accuracy in children presenting with an acute febrile illness to health facilities in a hard-to-reach rural area in Ghana. Nevertheless, discordant results recorded on day 0 and follow-up visits using the recommended RDTs means improved malaria diagnostic capability in malaria-endemic regions is necessary. |
| first_indexed | 2024-12-11T14:51:36Z |
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| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-11T14:51:36Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-285cfb73fb56455fad23194f8b8399bd2022-12-22T01:01:26ZengBMCMalaria Journal1475-28752018-12-011711910.1186/s12936-018-2613-xDiagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, GhanaIsabella A. Quakyi0George O. Adjei1David J. Sullivan2Amos Laar3Judith K. Stephens4Richmond Owusu5Peter Winch6Kwame S. Sakyi7Nathaniel Coleman8Francis D. Krampa9Edward Essuman10Vivian N. A. Aubyn11Isaac A. Boateng12Bernard B. Borteih13Linda Vanotoo14Juliet Tuakli15Ebenezer Addison16Constance Bart-Plange17Felix Sorvor18Andrew A. Adjei19Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaCentre for Tropical Clinical Pharmacology and Therapeutics, School of Medicine and Dentistry, University of GhanaDepartment of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public HealthDepartment of Population, Family, and Reproductive Health, School of Public Health, University of GhanaDepartment of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaDepartment of Health Policy, Planning and Management, School of Public Health, University of GhanaDepartment of International Health, Social and Behavioural Interventions Program, Johns Hopkins Bloomberg School of Public HealthDepartment of Public and Environmental Wellness, Oakland UniversityDepartment of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaDepartment of Biochemistry, Cell and Molecular Biology, University of GhanaDepartment of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaNational Malaria Control Programme, Ministry of HealthAsante-Akim Central Municipal Health Directorate, Ghana Health ServicesDepartment of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaRegional Health Directorate, Ghana Health ServicesChild and AssociatesKpone Katamanso District Health DirectorateNational Malaria Control Programme, Ministry of HealthDepartment of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of GhanaWorldwide Universities Network, University of GhanaAbstract Background This study seeks to compare the performance of HRP2 (First Response) and pLDH/HRP2 (Combo) RDTs for falciparum malaria against microscopy and PCR in acutely ill febrile children at presentation and follow-up. Methods This is an interventional study that recruited children < 5 years who reported to health facilities with a history of fever within the past 72 h or a documented axillary temperature of 37.5 °C. Using a longitudinal approach, recruitment and follow-up of participants was done between January and May 2012. Based on results of HRP2-RDT screening, the children were grouped into one of the following three categories: (1) tested positive for malaria using RDT and received anti-malarial treatment (group 1, n = 85); (2) tested negative for malaria using RDT and were given anti-malarial treatment by the admitting physician (group 2, n = 74); or, (3) tested negative for malaria using RDT and did not receive any anti-malarial treatment (group 3, n = 101). Independent microscopy, PCR and Combo-RDT tests were done for each sample on day 0 and all follow-up days. Results Mean age of the study participants was 22 months and females accounted for nearly 50%. At the time of diagnosis, the mean body temperature was 37.9 °C (range 35–40.1 °C). Microscopic parasite density ranged between 300 and 99,500 parasites/µL. With microscopy as gold standard, the sensitivity of HRP2 and Combo-RDTs were 95.1 and 96.3%, respectively. The sensitivities, specificities and predictive values for RDTs were relatively higher in microscopy-defined malaria cases than in PCR positive-defined cases. On day 0, participants who initially tested negative for HRP2 were positive by microscopy (n = 2), Combo (n = 1) and PCR (n = 17). On days 1 and 2, five of the children in this group (initially HRP2-negative) tested positive by PCR alone. On day 28, four patients who were originally HRP2-negative tested positive for microscopy (n = 2), Combo (n = 2) and PCR (n = 4). Conclusion The HRP2/pLDH RDTs showed comparable diagnostic accuracy in children presenting with an acute febrile illness to health facilities in a hard-to-reach rural area in Ghana. Nevertheless, discordant results recorded on day 0 and follow-up visits using the recommended RDTs means improved malaria diagnostic capability in malaria-endemic regions is necessary.http://link.springer.com/article/10.1186/s12936-018-2613-xFebrileChildren < 5 yearsRapid diagnostic test (RDT)MalariaHRP2Combo |
| spellingShingle | Isabella A. Quakyi George O. Adjei David J. Sullivan Amos Laar Judith K. Stephens Richmond Owusu Peter Winch Kwame S. Sakyi Nathaniel Coleman Francis D. Krampa Edward Essuman Vivian N. A. Aubyn Isaac A. Boateng Bernard B. Borteih Linda Vanotoo Juliet Tuakli Ebenezer Addison Constance Bart-Plange Felix Sorvor Andrew A. Adjei Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana Malaria Journal Febrile Children < 5 years Rapid diagnostic test (RDT) Malaria HRP2 Combo |
| title | Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana |
| title_full | Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana |
| title_fullStr | Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana |
| title_full_unstemmed | Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana |
| title_short | Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana |
| title_sort | diagnostic capacity and predictive values of rapid diagnostic tests for accurate diagnosis of plasmodium falciparum in febrile children in asante akim ghana |
| topic | Febrile Children < 5 years Rapid diagnostic test (RDT) Malaria HRP2 Combo |
| url | http://link.springer.com/article/10.1186/s12936-018-2613-x |
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