Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings

Malaria Journal

Research

Dan Nyehangane¹  Carolyn Nabasumba¹  Yap Boum²  Anne-Laure Page³  Francesco Grandesso³  Mathieu Bastard³  Jean-François Etard⁴  Martin De Smet⁵ 

[1] Epicentre Mbarara Research Centre, Mbarara, Uganda;Epicentre Mbarara Research Centre, Mbarara, Uganda;Mbarara University of Science and Technology, Mbarara, Uganda;Epicentre, 8 rue Saint-Sabin, Paris, France;Epicentre, 8 rue Saint-Sabin, Paris, France;UMI 233 TransVIHMI, Institut de Recherche pour le Développement, Université de Montpellier 1, 34000, Montpellier, France;Médecins Sans Frontières, Brussels, Belgium;

关键词: Malaria;    Fever;    Diagnostic;    Rapid diagnostic test;    Sensitivity;    Specificity;    Performance;    Negativity;   

DOI  :  10.1186/s12936-016-1529-6

 received in 2016-06-28, accepted in 2016-09-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe performance of different malaria rapid diagnostic tests (RDT) may be influenced by transmission intensity and by the length of time each test requires to become negative after treatment and patient’s recovery.MethodsResults of three RDTs (two HRP2 and one pLDH antigen-based tests) were compared to blood smear microscopy (the gold standard method) in children under 5 years of age living in a high versus low malaria intensity setting in southwestern Uganda. In each setting, 212 children, who tested positive by at least one RDT and by microscopy, were treated with artemether-lumefantrine. RDTs and microscopy were then repeated at fixed intervals to estimate each test’s time to negativity after treatment and patient recovery.ResultsIn the two settings, sensitivities ranged from 98.4 to 99.2 % for the HRP2 tests and 94.7 to 96.1 % for the pLDH test. Specificities were 98.9 and 98.8 % for the HRP2 tests and 99.7 % for the pLDH test in the low-transmission setting and 79.7, 80.7 and 93.9 %, respectively, in the high-transmission setting. Median time to become negative was 35–42 or more days for the HRP2 tests and 2 days for the pLDH test.ConclusionsHigh transmission contexts and a long time to become negative resulted in considerably reduced specificities for the HRP2 tests. Choice of RDT for low- versus high-transmission settings should balance risks and benefits of over-treatment versus missing malaria cases.Trial registration: Registry number at ClinicalTrial.gov: NCT01325974

【 授权许可】

CC BY   
© The Author(s) 2016