Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia
Abstract Background The sensitivity of rapid diagnostic tests (RDTs) for malaria is inadequate for detecting low-density, often asymptomatic infections, such as those that can occur when screening pregnant women for malaria. The performance of the Alere™ Ultra-sensitive Malaria Ag Plasmodium falcipa...
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ftdoajarticles:oai:doaj.org/article:c7e681ab7d3846c0b5cfcc79054455b0 2023-05-15T15:12:32+02:00 Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia Vera T. Unwin Rukhsana Ahmed Rintis Noviyanti Agatha M. Puspitasari Retno A. S. Utami Leily Trianty Theda Lukito Din Syafruddin Jeanne R. Poespoprodjo Maria A. Santana-Morales Feiko O. Ter Kuile Emily R. Adams 2020-01-01T00:00:00Z https://doi.org/10.1186/s12936-020-3110-6 https://doaj.org/article/c7e681ab7d3846c0b5cfcc79054455b0 EN eng BMC https://doi.org/10.1186/s12936-020-3110-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3110-6 1475-2875 https://doaj.org/article/c7e681ab7d3846c0b5cfcc79054455b0 Malaria Journal, Vol 19, Iss 1, Pp 1-8 (2020) Malaria Diagnostics Pregnancy Rapid diagnostic test Diagnostic performance Molecular techniques Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1186/s12936-020-3110-6 2022-12-31T12:08:14Z Abstract Background The sensitivity of rapid diagnostic tests (RDTs) for malaria is inadequate for detecting low-density, often asymptomatic infections, such as those that can occur when screening pregnant women for malaria. The performance of the Alere™ Ultra-sensitive Malaria Ag Plasmodium falciparum RDT (uRDT) was assessed retrospectively in pregnant women in Indonesia. Methods The diagnostic performance of the uRDT and the CareStart™ Malaria HRP2/pLDH VOM (Plasmodium vivax, Plasmodium ovale and Plasmodium malariae) Combo RDT (csRDT) were assessed using 270 stored red blood cell pellets and plasma samples from asymptomatic pregnant women. These included 112 P. falciparum negative and 158 P. falciparum positive samples detected by a composite test (qPCR, LAMP, nPCR) as reference standard. Diagnostic indicators: sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), diagnostic odds ratio (DOR) and the level of agreement (kappa) were calculated for comparison. Results Compared with the reference test, the uRDT had a sensitivity of 19.6% (95% CI 13.9–26.8) and specificity of 98.2% (93.1–99.7%). The csRDT was 22.8% (16.7–30.3) sensitive and 95.5% (89.4–98.3) specific for P. falciparum infections. Performance of the uRDT was non-significantly different to the csRDT (p = 0.169). RDT outcome was stratified by qPCR cycling threshold (Ct), and performance of the RDTs was found to be comparable across parasite loads. Conclusion The uRDT performed similarly to the currently used csRDTs in detecting P. falciparum infections in asymptomatic pregnant women. In these settings, molecular diagnostics are currently the most sensitive for malaria. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 19 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Malaria Diagnostics Pregnancy Rapid diagnostic test Diagnostic performance Molecular techniques Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Diagnostics Pregnancy Rapid diagnostic test Diagnostic performance Molecular techniques Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Vera T. Unwin Rukhsana Ahmed Rintis Noviyanti Agatha M. Puspitasari Retno A. S. Utami Leily Trianty Theda Lukito Din Syafruddin Jeanne R. Poespoprodjo Maria A. Santana-Morales Feiko O. Ter Kuile Emily R. Adams Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
topic_facet |
Malaria Diagnostics Pregnancy Rapid diagnostic test Diagnostic performance Molecular techniques Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The sensitivity of rapid diagnostic tests (RDTs) for malaria is inadequate for detecting low-density, often asymptomatic infections, such as those that can occur when screening pregnant women for malaria. The performance of the Alere™ Ultra-sensitive Malaria Ag Plasmodium falciparum RDT (uRDT) was assessed retrospectively in pregnant women in Indonesia. Methods The diagnostic performance of the uRDT and the CareStart™ Malaria HRP2/pLDH VOM (Plasmodium vivax, Plasmodium ovale and Plasmodium malariae) Combo RDT (csRDT) were assessed using 270 stored red blood cell pellets and plasma samples from asymptomatic pregnant women. These included 112 P. falciparum negative and 158 P. falciparum positive samples detected by a composite test (qPCR, LAMP, nPCR) as reference standard. Diagnostic indicators: sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), diagnostic odds ratio (DOR) and the level of agreement (kappa) were calculated for comparison. Results Compared with the reference test, the uRDT had a sensitivity of 19.6% (95% CI 13.9–26.8) and specificity of 98.2% (93.1–99.7%). The csRDT was 22.8% (16.7–30.3) sensitive and 95.5% (89.4–98.3) specific for P. falciparum infections. Performance of the uRDT was non-significantly different to the csRDT (p = 0.169). RDT outcome was stratified by qPCR cycling threshold (Ct), and performance of the RDTs was found to be comparable across parasite loads. Conclusion The uRDT performed similarly to the currently used csRDTs in detecting P. falciparum infections in asymptomatic pregnant women. In these settings, molecular diagnostics are currently the most sensitive for malaria. |
format |
Article in Journal/Newspaper |
author |
Vera T. Unwin Rukhsana Ahmed Rintis Noviyanti Agatha M. Puspitasari Retno A. S. Utami Leily Trianty Theda Lukito Din Syafruddin Jeanne R. Poespoprodjo Maria A. Santana-Morales Feiko O. Ter Kuile Emily R. Adams |
author_facet |
Vera T. Unwin Rukhsana Ahmed Rintis Noviyanti Agatha M. Puspitasari Retno A. S. Utami Leily Trianty Theda Lukito Din Syafruddin Jeanne R. Poespoprodjo Maria A. Santana-Morales Feiko O. Ter Kuile Emily R. Adams |
author_sort |
Vera T. Unwin |
title |
Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
title_short |
Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
title_full |
Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
title_fullStr |
Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
title_full_unstemmed |
Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia |
title_sort |
use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in indonesia |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12936-020-3110-6 https://doaj.org/article/c7e681ab7d3846c0b5cfcc79054455b0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 19, Iss 1, Pp 1-8 (2020) |
op_relation |
https://doi.org/10.1186/s12936-020-3110-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3110-6 1475-2875 https://doaj.org/article/c7e681ab7d3846c0b5cfcc79054455b0 |
op_doi |
https://doi.org/10.1186/s12936-020-3110-6 |
container_title |
Malaria Journal |
container_volume |
19 |
container_issue |
1 |
_version_ |
1766343203620913152 |