 | Francois Kiemde, Massa Dit Achille Bonko, Marc Christian Tahita, Palpouguini Lompo, Toussaint Rouamba, Halidou Tinto, Michael Boele 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 (Journal Article) In: Malar. J., vol. 16, no. 1, pp. 294, 2017, ISSN: 1475-2875. @article{Kiemde2017-el,
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},
author = {Francois Kiemde and Massa Dit Achille Bonko and Marc Christian Tahita and Palpouguini Lompo and Toussaint Rouamba and Halidou Tinto and Michael Boele Hensbroek and Petra F Mens and Henk D F H Schallig},
doi = {10.1186/s12936-017-1941-6},
issn = {1475-2875},
year = {2017},
date = {2017-07-01},
urldate = {2017-07-01},
journal = {Malar. J.},
volume = {16},
number = {1},
pages = {294},
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.},
keywords = {Accuracy; Diagnosis; Fever; Malaria; RDT-PfHRP2; Sensitivity; Specificity},
pubstate = {published},
tppubtype = {article}
}
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. |
