Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone
Abstract Background Most malaria rapid diagnostic tests (RDTs) use HRP2 detection, including Paracheck-Pf ® , but their utility is limited by persistent false positivity after treatment. PLDH-based tests become negative more quickly, but sensitivity has been reported below the recommended standard o...
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Online Access: | https://doi.org/10.1186/1475-2875-9-28 https://doaj.org/article/a2e74ca8f4f9420a805f702fd620eea0 |
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ftdoajarticles:oai:doaj.org/article:a2e74ca8f4f9420a805f702fd620eea0 2023-05-15T15:19:04+02:00 Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone De Smet Martin Mukhtar Ahmed Dunkley Sophie Gerstl Sibylle Baker Samuel Maikere Jacob 2010-01-01T00:00:00Z https://doi.org/10.1186/1475-2875-9-28 https://doaj.org/article/a2e74ca8f4f9420a805f702fd620eea0 EN eng BMC http://www.malariajournal.com/content/9/1/28 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-28 1475-2875 https://doaj.org/article/a2e74ca8f4f9420a805f702fd620eea0 Malaria Journal, Vol 9, Iss 1, p 28 (2010) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2010 ftdoajarticles https://doi.org/10.1186/1475-2875-9-28 2022-12-31T09:32:40Z Abstract Background Most malaria rapid diagnostic tests (RDTs) use HRP2 detection, including Paracheck-Pf ® , but their utility is limited by persistent false positivity after treatment. PLDH-based tests become negative more quickly, but sensitivity has been reported below the recommended standard of 90%. A new pLDH test, CareStart™ three-line P.f/PAN-pLDH, claims better sensitivity with continued rapid conversion to negative. The study aims were to 1) compare sensitivity and specificity of CareStart™ to Paracheck-Pf ® to diagnose falciparum malaria in children under five years of age, 2) assess how quickly false-positive CareStart™ tests become negative and 3) evaluate ease of use and inter-reader agreement of both tests. Methods Participants were included if they were aged between two and 59 months, presenting to a Médecins Sans Frontières community health centre in eastern Sierra Leone with suspected malaria defined as fever (axillary temperature > 37.5°C) and/or history of fever in the previous 72 hours and no signs of severe disease. The same capillary blood was used for the RDTs and the blood slide, the latter used as the gold standard reference. All positive participants were treated with supervised artesunate and amodiaquine treatment for three days. Participants with a persistent false-positive CareStart™, but a negative blood slide on Day 2, were followed with repeated CareStart™ and blood slide tests every seven days until CareStart™ became negative or a maximum of 28 days. Results Sensitivity of CareStart™ was 99.4% (CI 96.8-100.0, 168/169) and of Paracheck-Pf ® , 98.8% (95% CI 95.8-99.8, 167/169). Specificity of CareStart™ was 96.0% (CI 91.9-98.4, 167/174) and of Paracheck-Pf ® , 74.7% (CI 67.6-81.0, 130/174) (p < 0.001). Neither test showed any change in sensitivity with decreasing parasitaemia. Of the 155 eligible follow-up CareStart™ participants, 63.9% (99/155) had a false-positive test on day 2, 21.3% (33/155) on day 7, 5.8% (9/155) on day 14, 1.9% (3/155) on day 21 and 0.6% (1/155) on ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 9 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 De Smet Martin Mukhtar Ahmed Dunkley Sophie Gerstl Sibylle Baker Samuel Maikere Jacob Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Most malaria rapid diagnostic tests (RDTs) use HRP2 detection, including Paracheck-Pf ® , but their utility is limited by persistent false positivity after treatment. PLDH-based tests become negative more quickly, but sensitivity has been reported below the recommended standard of 90%. A new pLDH test, CareStart™ three-line P.f/PAN-pLDH, claims better sensitivity with continued rapid conversion to negative. The study aims were to 1) compare sensitivity and specificity of CareStart™ to Paracheck-Pf ® to diagnose falciparum malaria in children under five years of age, 2) assess how quickly false-positive CareStart™ tests become negative and 3) evaluate ease of use and inter-reader agreement of both tests. Methods Participants were included if they were aged between two and 59 months, presenting to a Médecins Sans Frontières community health centre in eastern Sierra Leone with suspected malaria defined as fever (axillary temperature > 37.5°C) and/or history of fever in the previous 72 hours and no signs of severe disease. The same capillary blood was used for the RDTs and the blood slide, the latter used as the gold standard reference. All positive participants were treated with supervised artesunate and amodiaquine treatment for three days. Participants with a persistent false-positive CareStart™, but a negative blood slide on Day 2, were followed with repeated CareStart™ and blood slide tests every seven days until CareStart™ became negative or a maximum of 28 days. Results Sensitivity of CareStart™ was 99.4% (CI 96.8-100.0, 168/169) and of Paracheck-Pf ® , 98.8% (95% CI 95.8-99.8, 167/169). Specificity of CareStart™ was 96.0% (CI 91.9-98.4, 167/174) and of Paracheck-Pf ® , 74.7% (CI 67.6-81.0, 130/174) (p < 0.001). Neither test showed any change in sensitivity with decreasing parasitaemia. Of the 155 eligible follow-up CareStart™ participants, 63.9% (99/155) had a false-positive test on day 2, 21.3% (33/155) on day 7, 5.8% (9/155) on day 14, 1.9% (3/155) on day 21 and 0.6% (1/155) on ... |
format |
Article in Journal/Newspaper |
author |
De Smet Martin Mukhtar Ahmed Dunkley Sophie Gerstl Sibylle Baker Samuel Maikere Jacob |
author_facet |
De Smet Martin Mukhtar Ahmed Dunkley Sophie Gerstl Sibylle Baker Samuel Maikere Jacob |
author_sort |
De Smet Martin |
title |
Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
title_short |
Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
title_full |
Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
title_fullStr |
Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
title_full_unstemmed |
Assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pLDH test results, in a hyperendemic falciparum malaria area, Sierra Leone |
title_sort |
assessment of two malaria rapid diagnostic tests in children under five years of age, with follow-up of false-positive pldh test results, in a hyperendemic falciparum malaria area, sierra leone |
publisher |
BMC |
publishDate |
2010 |
url |
https://doi.org/10.1186/1475-2875-9-28 https://doaj.org/article/a2e74ca8f4f9420a805f702fd620eea0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 9, Iss 1, p 28 (2010) |
op_relation |
http://www.malariajournal.com/content/9/1/28 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-28 1475-2875 https://doaj.org/article/a2e74ca8f4f9420a805f702fd620eea0 |
op_doi |
https://doi.org/10.1186/1475-2875-9-28 |
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Malaria Journal |
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9 |
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1766349259533189120 |