Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso)
(1) Background: Malaria control has strongly benefited from the implementation of rapid diagnostic tests (RDTs). The malaria RDTs used in Burkina Faso, as per the recommendation of the National Malaria Control Program, are based on the detection of histidine-rich protein-2 (<i>Pf</i>HRP2...
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MDPI AG
2022-12-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/7/12/440 |
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| author | Massa dit Achille Bonko Marc Christian Tahita Francois Kiemde Palpouguini Lompo Petra F. Mens Halidou Tinto Henk. D. F. H. Schallig |
| author_facet | Massa dit Achille Bonko Marc Christian Tahita Francois Kiemde Palpouguini Lompo Petra F. Mens Halidou Tinto Henk. D. F. H. Schallig |
| author_sort | Massa dit Achille Bonko |
| collection | DOAJ |
| description | (1) Background: Malaria control has strongly benefited from the implementation of rapid diagnostic tests (RDTs). The malaria RDTs used in Burkina Faso, as per the recommendation of the National Malaria Control Program, are based on the detection of histidine-rich protein-2 (<i>Pf</i>HRP2) specific to <i>Plasmodium falciparum</i>, which is the principal plasmodial species causing malaria in Burkina Faso. However, there is increasing concern about the diagnostic performance of these RDTs in field situations, and so constant monitoring of their accuracy is warranted. (2) Methods: A prospective study was performed in the health district of Nanoro, where 391 febrile children under 5 years with an axillary temperature ≥37.5 °C presenting at participating health facilities were subjected to testing for malaria. The HRP2-based RDT and expert microscopy were used to determine the diagnostic performance of the former. Retrospectively, the correctness of the antimalaria prescriptions was reviewed. (3) Results: Taking expert malaria microscopy as the gold standard, the sensitivity of the employed RDT was 98.5% and the specificity 40.5%, with a moderate agreement between the RDT testing and microscopy. In total, 21.7% of cases received an inappropriate antimalarial treatment based on a retrospective assessment with expert microscopy results. (4) Conclusion: Malaria remains one of the principal causes of febrile illness in Burkina Faso. Testing with HRP2-based RDTs is inaccurate, in particular, due to the low specificity, which results in an over-prescription of antimalarials, with emerging antimalarial drug resistance as an important risk and many children not being treated for potential other causes of fever. |
| first_indexed | 2024-03-09T15:46:57Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-09T15:46:57Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-b50bee4873cc48bf98a919fbbe4186b12023-11-24T18:28:39ZengMDPI AGTropical Medicine and Infectious Disease2414-63662022-12-0171244010.3390/tropicalmed7120440Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso)Massa dit Achille Bonko0Marc Christian Tahita1Francois Kiemde2Palpouguini Lompo3Petra F. Mens4Halidou Tinto5Henk. D. F. H. Schallig6Institut de Recherche en Sciences de la Santé-Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, (IRSS-DRCO/URCN), Nanoro 18, Burkina FasoInstitut de Recherche en Sciences de la Santé-Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, (IRSS-DRCO/URCN), Nanoro 18, Burkina FasoInstitut de Recherche en Sciences de la Santé-Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, (IRSS-DRCO/URCN), Nanoro 18, Burkina FasoInstitut de Recherche en Sciences de la Santé-Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, (IRSS-DRCO/URCN), Nanoro 18, Burkina FasoLaboratory for Experimental Parasitology, Amsterdam University Medical Centers, Department of Medical Microbiology and Infection Prevention, Academic Medical Center at the University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsInstitut de Recherche en Sciences de la Santé-Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, (IRSS-DRCO/URCN), Nanoro 18, Burkina FasoLaboratory for Experimental Parasitology, Amsterdam University Medical Centers, Department of Medical Microbiology and Infection Prevention, Academic Medical Center at the University of Amsterdam, 1105 AZ Amsterdam, The Netherlands(1) Background: Malaria control has strongly benefited from the implementation of rapid diagnostic tests (RDTs). The malaria RDTs used in Burkina Faso, as per the recommendation of the National Malaria Control Program, are based on the detection of histidine-rich protein-2 (<i>Pf</i>HRP2) specific to <i>Plasmodium falciparum</i>, which is the principal plasmodial species causing malaria in Burkina Faso. However, there is increasing concern about the diagnostic performance of these RDTs in field situations, and so constant monitoring of their accuracy is warranted. (2) Methods: A prospective study was performed in the health district of Nanoro, where 391 febrile children under 5 years with an axillary temperature ≥37.5 °C presenting at participating health facilities were subjected to testing for malaria. The HRP2-based RDT and expert microscopy were used to determine the diagnostic performance of the former. Retrospectively, the correctness of the antimalaria prescriptions was reviewed. (3) Results: Taking expert malaria microscopy as the gold standard, the sensitivity of the employed RDT was 98.5% and the specificity 40.5%, with a moderate agreement between the RDT testing and microscopy. In total, 21.7% of cases received an inappropriate antimalarial treatment based on a retrospective assessment with expert microscopy results. (4) Conclusion: Malaria remains one of the principal causes of febrile illness in Burkina Faso. Testing with HRP2-based RDTs is inaccurate, in particular, due to the low specificity, which results in an over-prescription of antimalarials, with emerging antimalarial drug resistance as an important risk and many children not being treated for potential other causes of fever.https://www.mdpi.com/2414-6366/7/12/440malariadiagnosticsBurkina Fasofebrile diseases |
| spellingShingle | Massa dit Achille Bonko Marc Christian Tahita Francois Kiemde Palpouguini Lompo Petra F. Mens Halidou Tinto Henk. D. F. H. Schallig Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) Tropical Medicine and Infectious Disease malaria diagnostics Burkina Faso febrile diseases |
| title | Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) |
| title_full | Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) |
| title_fullStr | Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) |
| title_full_unstemmed | Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) |
| title_short | Diagnostic Performance of <i>Plasmodium falciparum</i> Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso) |
| title_sort | diagnostic performance of i plasmodium falciparum i histidine rich protein 2 antigen specific rapid diagnostic test in children at the peripheral health care level in nanoro burkina faso |
| topic | malaria diagnostics Burkina Faso febrile diseases |
| url | https://www.mdpi.com/2414-6366/7/12/440 |
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