Bayesian evaluation of the performance of three diagnostic tests for Plasmodium falciparum infection in a low-transmission setting in Kilifi County, Kenya

Wellcome Open Research

article

Marshal M. Mweu¹  Juliana Wambua²  Fixtan Njuga²  Philip Bejon²  Daniel Mwanga² 

[1] School of Public Health, University of Nairobi;KEMRI-Wellcome Trust Research Programme;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford

关键词: Bayesian latent class model;    Plasmodium falciparum;    Light microscopy;    Rapid diagnostic test;    PCR;    Test evaluation;   

DOI  :  10.12688/wellcomeopenres.15204.3

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: Central to the successful elimination ofPlasmodium falciparum malaria, are tests with superior capability of diagnosing low-density parasitaemias. Empirical evidence on the performance of the commonly available diagnostics (light microscopy (LM), rapid diagnostic tests (RDT) and polymerase chain reaction (PCR)) is needed to better inform case management and surveillance activities within primary health care settings where elimination offalciparum malaria is targeted. The objective of this study was to estimate the sensitivity (Se) and specificity (Sp) and predictive values of LM, RDT and PCR tests forP. falciparum infection in children, while evaluating the effect of specific covariates on the accuracy of the tests.Methods: The study enrolled 1,563 children presenting with fever (axillary temperature ≥ 37.50C) to the Ngerenya dispensary, Kilifi County between March and December 2014. A Bayesian latent class model (BLCM) was fitted to the participants’ diagnostic data obtained from blood samples that were screened for the presence ofP. falciparum using the three tests.Results:98%.Conclusions: LM and RDT afford high Se and Sp in symptomatic care-seeking children in this lowP. falciparum prevalence setting. A serial combination of the tests assures high PPV and NPV estimates. These elements, coupled with the wide deployment and affordability of the tests, lend the tests useful for guiding clinical care and surveillance activities forP. falciparum within elimination settings.

【 授权许可】

CC BY