Field evaluation of HRP2 and pan pLDH-based immunochromatographic assay in therapeutic monitoring of uncomplicated falciparum malaria in Myanmar

Malaria Journal

Research

Myat P Kyaw¹  Myat H Nyunt¹  Khin M Myint²  Khin M Nyunt²  Kyu K Win³ 

[1] Department of Medical Research, (Lower Myanmar), Republic of the Union of Myanmar;District Health Department, Myawaddy District, Myawaddy, Republic of the Union of Myanmar;University of Medicine, Yangon, Republic of the Union of Myanmar;

关键词: Malaria;    RDT;    Treatment monitoring;    HRP2;    pLDH;   

DOI  :  10.1186/1475-2875-12-123

 received in 2013-02-06, accepted in 2013-04-06,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMalaria rapid diagnostic tests (RDT) are used for diagnostic purpose in malaria-endemic areas where reliable microscopy is not available. Persistence of the antigenaemia causes over-diagnosis and may limit the usefulness of the RDT in monitoring treatment. In this study, the usefulness of histidine-rich protein-2 (HRP2) and pan-specific or species-specific Plasmodium lactate dehydrogenase (pLDH) in treatment monitoring of uncomplicated falciparum malaria was carried out in an endemic setting in Myanmar.MethodsA prospective longitudinal, single-arm, cohort study was done by microscopy to confirm Plasmodium falciparum mono-infected cases. After direct treatment with an artemether-lumefantrine combination, patients were followed up on day 3, 7, 14, 21, 28 and any other day of recurrent fever. Blood film examination and RDT were carried out on day 0 and all follow-up days.ResultsOut of 77 recruited falciparum cases, 63 became adequate clinical and parasitological response (ACPR) cases, and 60.3% of them were still positive for HRP2 up to day 28. Eleven out of 12 treatment failure cases (91.6%) were detected by pan pLDH. The mean duration required to become negative of HRP2 was 20 days (SD ± 6.03) and that of pan pLDH was six days with or without gametocytes and 3.7 days without gametocytes.ConclusionAlthough treatment monitoring cannot be performed by HRP2, it can be assessed by pan pLDH-based assay after day 3 if a gametocidal drug has been administered and after day 7 if the presence of gametocytes was not excluded. The pan pLDH-based assay was a suitable test to monitor the treatment response of uncomplicated falciparum malaria patients.

【 授权许可】

CC BY   
© Nyunt et al.; licensee BioMed Central Ltd. 2013