Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission
Abstract Background It remains challenging to distinguish malaria from other fever causing infections, as a positive rapid diagnostic test does not always signify a true active malaria infection. This study was designed to determine the influence of other causes of fever, prior anti-malarial treatme...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-017-1941-6 |
| _version_ | 1818317591417978880 |
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| author | Francois Kiemde Massa dit Achille Bonko Marc Christian Tahita Palpouguini Lompo Toussaint Rouamba Halidou Tinto Michael Boele van Hensbroek Petra F. Mens Henk D. F. H. Schallig |
| author_facet | Francois Kiemde Massa dit Achille Bonko Marc Christian Tahita Palpouguini Lompo Toussaint Rouamba Halidou Tinto Michael Boele van Hensbroek Petra F. Mens Henk D. F. H. Schallig |
| author_sort | Francois Kiemde |
| collection | DOAJ |
| description | Abstract Background It remains challenging to distinguish malaria from other fever causing infections, as a positive rapid diagnostic test does not always signify a true active malaria infection. This study was designed to determine the influence of other causes of fever, prior anti-malarial treatment, and a possible seasonality of the performance of a PfHRP2 RDT for the diagnosis of malaria in children under-5 years of age living in a malaria endemic area. Methods A prospective etiology study was conducted in 2015 among febrile children under 5 years of age in Burkina Faso. In order to assess the influence of other febrile illnesses, prior treatment and seasonality on the performance of a PfHRP2 RDT in diagnosing malaria, the RDT results were compared with the gold standard (expert microscopic diagnosis of Plasmodium falciparum) and test results were analysed by assuming that prior anti-malarial use and bacterial/viral infection status would have been known prior to testing. To assess bacterial and viral infection status blood, urine and stool samples were analysed. Results In total 683 blood samples were analysed with microscopy and RDT-PfHRP2. Plasmodium falciparum malaria was diagnosed in 49.8% (340/683) by microscopy compared to 69.5% (475/683) by RDT-PfHRP2. The RDT-PfHRP2 reported 29.7% (141/475) false positive results and 1.8% (6/340) false negative cases. The RDT-PfHRP2 had a high sensitivity (98.2%) and negative predictive value (97.1%), but a low specificity (58.9%) and positive predictive value (70.3%). Almost 50% of the alternative cause of fever were diagnosed by laboratory testing in the RDT false positive malaria group. Conclusions The use of a malaria RDT-PfHRP2 in a malaria endemic area may cause misdiagnosis of the actual cause of fever due to false positive test results. The development of a practical diagnostic tool to screen for other causes of fever in malaria endemic areas is required to save lives. |
| first_indexed | 2024-12-13T09:39:45Z |
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| id | doaj.art-cfa756bf12094c99be33b2014ed10d31 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-13T09:39:45Z |
| publishDate | 2017-07-01 |
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| series | Malaria Journal |
| spelling | doaj.art-cfa756bf12094c99be33b2014ed10d312022-12-21T23:52:14ZengBMCMalaria Journal1475-28752017-07-0116111110.1186/s12936-017-1941-6Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmissionFrancois Kiemde0Massa dit Achille Bonko1Marc Christian Tahita2Palpouguini Lompo3Toussaint Rouamba4Halidou Tinto5Michael Boele van Hensbroek6Petra F. Mens7Henk D. F. H. Schallig8Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroInstitut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroInstitut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroInstitut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroInstitut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroInstitut de Recherche en Science de la Sante-Unite de Recherche Clinique de NanoroGlobal Child Health Group, Academic Medical Centre, University of AmsterdamDepartment of Medical Microbiology, Academic Medical Centre, Parasitology UnitDepartment of Medical Microbiology, Academic Medical Centre, Parasitology UnitAbstract Background It remains challenging to distinguish malaria from other fever causing infections, as a positive rapid diagnostic test does not always signify a true active malaria infection. This study was designed to determine the influence of other causes of fever, prior anti-malarial treatment, and a possible seasonality of the performance of a PfHRP2 RDT for the diagnosis of malaria in children under-5 years of age living in a malaria endemic area. Methods A prospective etiology study was conducted in 2015 among febrile children under 5 years of age in Burkina Faso. In order to assess the influence of other febrile illnesses, prior treatment and seasonality on the performance of a PfHRP2 RDT in diagnosing malaria, the RDT results were compared with the gold standard (expert microscopic diagnosis of Plasmodium falciparum) and test results were analysed by assuming that prior anti-malarial use and bacterial/viral infection status would have been known prior to testing. To assess bacterial and viral infection status blood, urine and stool samples were analysed. Results In total 683 blood samples were analysed with microscopy and RDT-PfHRP2. Plasmodium falciparum malaria was diagnosed in 49.8% (340/683) by microscopy compared to 69.5% (475/683) by RDT-PfHRP2. The RDT-PfHRP2 reported 29.7% (141/475) false positive results and 1.8% (6/340) false negative cases. The RDT-PfHRP2 had a high sensitivity (98.2%) and negative predictive value (97.1%), but a low specificity (58.9%) and positive predictive value (70.3%). Almost 50% of the alternative cause of fever were diagnosed by laboratory testing in the RDT false positive malaria group. Conclusions The use of a malaria RDT-PfHRP2 in a malaria endemic area may cause misdiagnosis of the actual cause of fever due to false positive test results. The development of a practical diagnostic tool to screen for other causes of fever in malaria endemic areas is required to save lives.http://link.springer.com/article/10.1186/s12936-017-1941-6RDT-PfHRP2DiagnosisMalariaFeverSensitivitySpecificity |
| spellingShingle | Francois Kiemde Massa dit Achille Bonko Marc Christian Tahita Palpouguini Lompo Toussaint Rouamba Halidou Tinto Michael Boele van Hensbroek Petra F. Mens Henk D. F. H. Schallig Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission Malaria Journal RDT-PfHRP2 Diagnosis Malaria Fever Sensitivity Specificity |
| title | Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission |
| title_full | Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission |
| title_fullStr | Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission |
| title_full_unstemmed | Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission |
| title_short | Accuracy of a Plasmodium falciparum specific histidine-rich protein 2 rapid diagnostic test in the context of the presence of non-malaria fevers, prior anti-malarial use and seasonal malaria transmission |
| title_sort | accuracy of a plasmodium falciparum specific histidine rich protein 2 rapid diagnostic test in the context of the presence of non malaria fevers prior anti malarial use and seasonal malaria transmission |
| topic | RDT-PfHRP2 Diagnosis Malaria Fever Sensitivity Specificity |
| url | http://link.springer.com/article/10.1186/s12936-017-1941-6 |
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