Performance of three multi-species rapid diagnostic tests for diagnosis of Plasmodium falciparum and Plasmodium vivax malaria in Oromia Regional State, Ethiopia

Malaria Journal

Research

Bonnie Cundill¹  Jan H Kolaczinski²  Takele Kefyalew³  Gezahegn Tesfaye³  Ruth A Ashton⁴  Helen Counihan⁵  Damtew Yadeta⁶  Richard Reithinger⁷ 

[1] London School of Hygiene & Tropical Medicine, Keppel Street, London, UK;Malaria Consortium - Africa Regional Office, PO Box 8045, Plot 2, Sturrock Road, Kampala, Uganda;London School of Hygiene & Tropical Medicine, Keppel Street, London, UK;Malaria Consortium - Ethiopia Office, PO Box 100224, Ethio-China Road, Addis Ababa, Ethiopia;Malaria Consortium - Ethiopia Office, PO Box 100224, Ethio-China Road, Addis Ababa, Ethiopia;Malaria Consortium - Africa Regional Office, PO Box 8045, Plot 2, Sturrock Road, Kampala, Uganda;Malaria Consortium International, Development House 56-64, Leonard Street, EC2A, 4LT, London, UK;Oromia Regional Health Bureau, PO Box 24341, Addis Ababa, Ethiopia;U.S. Agency for International Development, Addis Ababa, Ethiopia;

关键词: Malaria;    Parasite Density;    Health Post;    Artemisinin Combination Therapy;    Vivax Infection;   

DOI  :  10.1186/1475-2875-9-297

 received in 2010-06-30, accepted in 2010-10-27,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMalaria transmission in Ethiopia is unstable and variable, caused by both Plasmodium falciparum and Plasmodium vivax. The Federal Ministry of Health (FMoH) is scaling up parasitological diagnosis of malaria at all levels of the health system; at peripheral health facilities this will be through use of rapid diagnostic tests (RDTs). The present study compared three RDT products to provide the FMoH with evidence to guide appropriate product selection.MethodsPerformance of three multi-species (pf-HRP2/pan-pLDH and pf-HRP2/aldolase) RDTs (CareStart®, ParaScreen® and ICT Combo®) was compared with 'gold standard' microscopy at three health centres in Jimma zone, Oromia Regional State. Ease of RDT use by health extension workers was assessed at community health posts. RDT heat stability was tested in a controlled laboratory setting according to WHO procedures.ResultsA total of 2,383 patients with suspected malaria were enrolled between May and July 2009, 23.2% of whom were found to be infected with Plasmodium parasites by microscopy. All three RDTs were equally sensitive in detecting P. falciparum or mixed infection: 85.6% (95% confidence interval 81.2-89.4). RDT specificity was similar for detection of P. falciparum or mixed infection at around 92%. For detecting P. vivax infection, all three RDTs had similar sensitivity in the range of 82.5 to 85.0%. CareStart had higher specificity in detecting P. vivax (97.2%) than both ParaScreen and ICT Combo (p < 0.001 and p = 0.05, respectively). Health extension workers preferred CareStart and ParaScreen to ICT Combo due to the clear labelling of bands on the cassette, while the 'lab in a pack' style of CareStart was the preferred design. ParaScreen and CareStart passed all heat stability testing, while ICT Combo did not perform as well.ConclusionsCareStart appeared to be the most appropriate option for use at health posts in Ethiopia, considering the combination of quantitative performance, ease of use and heat stability. When new products become available, the choice of multi-species RDT for Ethiopia should be regularly re-evaluated, as it would be desirable to identify a test with higher sensitivity than the ones evaluated here.

【 授权许可】

CC BY   
© Ashton et al; licensee BioMed Central Ltd. 2010