Performance of Rapid Diagnostic Tests for Imported Malaria in Clinical Practice: Results of a National Multicenter Study
Year: 2013
Type: article
Study design: Observational Study
Abstract: We compared the performance of four rapid diagnostic tests (RDTs) for imported malaria, and particularly Plasmodium falciparum infection, using thick and thin blood smears as the gold standard. All the tests are designed to detect at least one protein specific to P. falciparum (Plasmodium histidine-rich protein 2 (PfHRP2) or Plasmodium LDH (PfLDH)) and one pan-Plasmodium protein (aldolase or Plasmodium LDH (pLDH)). 1,311 consecutive patients presenting to 9 French hospitals with suspected malaria were included in this prospective study between April 2006 and September 2008. Blood smears revealed malaria parasites in 374 cases (29%). For the diagnosis of P. falciparum infection, the three tests detecting PfHRP2 showed high and similar sensitivity (96%), positive predictive value (PPV) (90%) and negative predictive value (NPV) (98%). The PfLDH test showed lower sensitivity (83%) and NPV (80%), despite good PPV (98%). For the diagnosis of non-falciparum species, the PPV and NPV of tests targeting pLDH or aldolase were 94-99% and 52-64%, respectively. PfHRP2-based RDTs are thus an acceptable alternative to routine microscopy for diagnosing P. falciparum malaria. However, as malaria may be misdiagnosed with RDTs, all negative results must be confirmed by the reference diagnostic method when clinical, biological or other factors are highly suggestive of malaria.
Source: PLoS ONE
Authors: Sandrine Houzé, Isabelle Boutron, Anne Marmorat, Marie Dalichampt, Christophe Choquet, Isabelle Poilane, Nadine Godineau, Anne-Sophie Le Guern, Marc Thellier, Hélène Broutier, Odile Fenneteau, Pascal Millet, Stéphanie Dulucq, Véronique Hubert, Pascal Houzé, Florence Tubach, Jacques Le Bras, Sophie Matheron
Institutions: Santé Internationale de la mère et de l'enfant, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Institut de Recherche pour le Développement, Université Paris Descartes, Sorbonne Paris Cité, Hôtel-Dieu de Paris, Hôpital Jean-Verdier, Centre Hospitalier Saint-Denis, Institut Pasteur, Pitié-Salpêtrière Hospital, Centre hospitalier Robert-Ballanger, Hôpital Robert-Debré, Laboratoire d'hématologie, Hôpital Saint-André, Université Bordeaux Segalen, Hôpital Pellegrin, Laboratoire de Biochimie, Hôpital Saint-Louis, Inserm, Université Paris Diderot
Language: English
Topic: Malaria Research and Control
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W1983409935