Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan
Abstract Background Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity...
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ftdoajarticles:oai:doaj.org/article:dabd822dda704dc694e4da31f873f9c3 2023-05-15T15:18:34+02:00 Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan Emily Lynch Tomas O. Jensen Bachir Assao Menard Chihana Thadeous Turuho Dan Nyehangane John B. Manyok Harriet Pasquale Nimol Khim Benoit Witkowski Matthew E. Coldiron 2022-09-01T00:00:00Z https://doi.org/10.1186/s12936-022-04280-w https://doaj.org/article/dabd822dda704dc694e4da31f873f9c3 EN eng BMC https://doi.org/10.1186/s12936-022-04280-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04280-w 1475-2875 https://doaj.org/article/dabd822dda704dc694e4da31f873f9c3 Malaria Journal, Vol 21, Iss 1, Pp 1-8 (2022) Malaria Rapid diagnostic test Plasmodium lactate dehydrogenase Histidine-rich protein 2 South Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1186/s12936-022-04280-w 2022-12-30T22:05:26Z Abstract Background Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions. Methods The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing. Results Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%. Conclusions The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 21 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Malaria Rapid diagnostic test Plasmodium lactate dehydrogenase Histidine-rich protein 2 South Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Rapid diagnostic test Plasmodium lactate dehydrogenase Histidine-rich protein 2 South Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Emily Lynch Tomas O. Jensen Bachir Assao Menard Chihana Thadeous Turuho Dan Nyehangane John B. Manyok Harriet Pasquale Nimol Khim Benoit Witkowski Matthew E. Coldiron Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
topic_facet |
Malaria Rapid diagnostic test Plasmodium lactate dehydrogenase Histidine-rich protein 2 South Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions. Methods The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing. Results Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%. Conclusions The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and ... |
format |
Article in Journal/Newspaper |
author |
Emily Lynch Tomas O. Jensen Bachir Assao Menard Chihana Thadeous Turuho Dan Nyehangane John B. Manyok Harriet Pasquale Nimol Khim Benoit Witkowski Matthew E. Coldiron |
author_facet |
Emily Lynch Tomas O. Jensen Bachir Assao Menard Chihana Thadeous Turuho Dan Nyehangane John B. Manyok Harriet Pasquale Nimol Khim Benoit Witkowski Matthew E. Coldiron |
author_sort |
Emily Lynch |
title |
Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
title_short |
Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
title_full |
Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
title_fullStr |
Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
title_full_unstemmed |
Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan |
title_sort |
evaluation of hrp2 and pldh-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in aweil, south sudan |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s12936-022-04280-w https://doaj.org/article/dabd822dda704dc694e4da31f873f9c3 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 21, Iss 1, Pp 1-8 (2022) |
op_relation |
https://doi.org/10.1186/s12936-022-04280-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04280-w 1475-2875 https://doaj.org/article/dabd822dda704dc694e4da31f873f9c3 |
op_doi |
https://doi.org/10.1186/s12936-022-04280-w |
container_title |
Malaria Journal |
container_volume |
21 |
container_issue |
1 |
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1766348766988730368 |