Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings
Abstract Background The 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. Methods Results of three RDTs (two HRP2 and one pLDH antigen-based...
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doaj-9ad58fa889f44340ba844e808201ce652020-11-24T22:36:05ZengBMCMalaria Journal1475-28752016-10-0115111210.1186/s12936-016-1529-6Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settingsFrancesco Grandesso0Carolyn Nabasumba1Dan Nyehangane2Anne-Laure Page3Mathieu Bastard4Martin De Smet5Yap Boum6Jean-François Etard7EpicentreEpicentre Mbarara Research CentreEpicentre Mbarara Research CentreEpicentreEpicentreMédecins Sans FrontièresEpicentre Mbarara Research CentreEpicentreAbstract Background The 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. Methods Results 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. Results In 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. Conclusions High 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: NCT01325974http://link.springer.com/article/10.1186/s12936-016-1529-6MalariaFeverDiagnosticRapid diagnostic testSensitivitySpecificity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francesco Grandesso Carolyn Nabasumba Dan Nyehangane Anne-Laure Page Mathieu Bastard Martin De Smet Yap Boum Jean-François Etard |
spellingShingle |
Francesco Grandesso Carolyn Nabasumba Dan Nyehangane Anne-Laure Page Mathieu Bastard Martin De Smet Yap Boum Jean-François Etard Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings Malaria Journal Malaria Fever Diagnostic Rapid diagnostic test Sensitivity Specificity |
author_facet |
Francesco Grandesso Carolyn Nabasumba Dan Nyehangane Anne-Laure Page Mathieu Bastard Martin De Smet Yap Boum Jean-François Etard |
author_sort |
Francesco Grandesso |
title |
Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
title_short |
Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
title_full |
Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
title_fullStr |
Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
title_full_unstemmed |
Performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
title_sort |
performance and time to become negative after treatment of three malaria rapid diagnostic tests in low and high malaria transmission settings |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2016-10-01 |
description |
Abstract Background The 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. Methods Results 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. Results In 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. Conclusions High 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 |
topic |
Malaria Fever Diagnostic Rapid diagnostic test Sensitivity Specificity |
url |
http://link.springer.com/article/10.1186/s12936-016-1529-6 |
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