Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.

BACKGROUND: Rapid diagnostic tests (RDTs) now play an important role in the diagnosis of falciparum malaria in many countries where the disease is endemic. Although these tests have been extensively evaluated in uncomplicated falciparum malaria, reliable data on their performance for diagnosing pote...

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Main Authors: Hendriksen, I, Mtove, G, Pedro, A, Gomes, E, Silamut, K, Lee, S, Mwambuli, A, Gesase, S, Reyburn, H, Day, N, White, N, von Seidlein, L, Dondorp, A
Format: Journal article
Language:English
Published: 2011
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author Hendriksen, I
Mtove, G
Pedro, A
Gomes, E
Silamut, K
Lee, S
Mwambuli, A
Gesase, S
Reyburn, H
Day, N
White, N
von Seidlein, L
Dondorp, A
author_facet Hendriksen, I
Mtove, G
Pedro, A
Gomes, E
Silamut, K
Lee, S
Mwambuli, A
Gesase, S
Reyburn, H
Day, N
White, N
von Seidlein, L
Dondorp, A
author_sort Hendriksen, I
collection OXFORD
description BACKGROUND: Rapid diagnostic tests (RDTs) now play an important role in the diagnosis of falciparum malaria in many countries where the disease is endemic. Although these tests have been extensively evaluated in uncomplicated falciparum malaria, reliable data on their performance for diagnosing potentially lethal severe malaria is lacking. METHODS: We compared a Plasmodium falciparum histidine-rich-protein2 (PfHRP₂)-based RDT and a Plasmodium lactate dehydrogenase (pLDH)-based RDT with routine microscopy of a peripheral blood slide and expert microscopy as a reference standard for the diagnosis of severe malaria in 1898 children who presented with severe febrile illness at 2 centers in Mozambique and Tanzania. RESULTS: The overall sensitivity, specificity, positive predictive value, and negative predictive values of the PfHRP₂-based test were 94.0%, 70.9%, 85.4%, and 86.8%, respectively, and for the pLDH-based test, the values were 88.0%, 88.3%, 93.2%, and 80.3%, respectively. At parasite counts < 1000 parasites/μL (n = 173), sensitivity of the pLDH-based test was low (45.7%), compared with that of the PfHRP₂-based test (69.9%). Both RDTs performed better than did the routine slide reading in a clinical laboratory as assessed in 1 of the centers. CONCLUSION: The evaluated PfHRP2-based RDT is an acceptable alternative to routine microscopy for diagnosing severe malaria in African children and performed better than did the evaluated pLDH-based RDT.
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spelling oxford-uuid:d44121b0-0dbf-4318-a667-3b8453a02d772022-03-27T08:17:09ZEvaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d44121b0-0dbf-4318-a667-3b8453a02d77EnglishSymplectic Elements at Oxford2011Hendriksen, IMtove, GPedro, AGomes, ESilamut, KLee, SMwambuli, AGesase, SReyburn, HDay, NWhite, Nvon Seidlein, LDondorp, ABACKGROUND: Rapid diagnostic tests (RDTs) now play an important role in the diagnosis of falciparum malaria in many countries where the disease is endemic. Although these tests have been extensively evaluated in uncomplicated falciparum malaria, reliable data on their performance for diagnosing potentially lethal severe malaria is lacking. METHODS: We compared a Plasmodium falciparum histidine-rich-protein2 (PfHRP₂)-based RDT and a Plasmodium lactate dehydrogenase (pLDH)-based RDT with routine microscopy of a peripheral blood slide and expert microscopy as a reference standard for the diagnosis of severe malaria in 1898 children who presented with severe febrile illness at 2 centers in Mozambique and Tanzania. RESULTS: The overall sensitivity, specificity, positive predictive value, and negative predictive values of the PfHRP₂-based test were 94.0%, 70.9%, 85.4%, and 86.8%, respectively, and for the pLDH-based test, the values were 88.0%, 88.3%, 93.2%, and 80.3%, respectively. At parasite counts < 1000 parasites/μL (n = 173), sensitivity of the pLDH-based test was low (45.7%), compared with that of the PfHRP₂-based test (69.9%). Both RDTs performed better than did the routine slide reading in a clinical laboratory as assessed in 1 of the centers. CONCLUSION: The evaluated PfHRP2-based RDT is an acceptable alternative to routine microscopy for diagnosing severe malaria in African children and performed better than did the evaluated pLDH-based RDT.
spellingShingle Hendriksen, I
Mtove, G
Pedro, A
Gomes, E
Silamut, K
Lee, S
Mwambuli, A
Gesase, S
Reyburn, H
Day, N
White, N
von Seidlein, L
Dondorp, A
Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title_full Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title_fullStr Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title_full_unstemmed Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title_short Evaluation of a PfHRP2 and a pLDH-based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of African children.
title_sort evaluation of a pfhrp2 and a pldh based rapid diagnostic test for the diagnosis of severe malaria in 2 populations of african children
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