Comparison of Malaria Rapid Diagnostic Test Kit and Microscopy

Background: The use of malaria rapid diagnostic test(RDT) enables targeted treatment that mitigates against the development of parasite drug resistance. With detection thresholds at ≥200 parasites/μL, their diagnostic performance in pregnant women may be challenging as asymptomatic infections with low parasite densities are common. Few data exist on the performance of histidine-rich protein-2 (HRP2) RDTs in Ghanaian pregnant women considering commonly occurring low parasite densities. Objective: The study sought to contribute more knowledge on test performance on First Response® test kit to guide the continuous evaluation of HRP2 RDTs in pregnancy. Methods: As part of an antimalarial drug trial in pregnancy, First Response® RDT results were compared to microscopy of peripheral blood slides in 1664 women. The diagnostic performance indicators were computed as proportions with 95% confidence intervals. The risk of having a positive RDT result was computed for age, gravidity and parasite density using binomial regression methods. Results: Parasitaemia prevalence by microscopy was 5.71%(n =95/1664) while that by RDT was 21.57%(n = 359/1664). Sensitivity was 82.11% (n=78/95), specificity was 82.09% (n=1288/1569), positive predictive value was 21.73% (n=78/359), and the likelihood ratio for a positive test was 4.58. False-negative RDT results were recorded for low parasite densities as well as densities ≥ 200/ μL while false-positive results were recorded in 281of 1664 tests. Primigravidae and younger aged women were more likely to have positive RDT results compared to multigravidae and women aged ≥ 30 yr. Conclusion: The moderate sensitivity, specificity and other diagnostic parameters reported suggest the First Response® malaria RDT is useful for detecting peripheral parasitaemia in pregnant women but the use of HRP2-only RDTs is limited by the existence of parasites with HRP2 gene deletion. The use of RDTs based on combined antigens continues to be recommended. Further research is needed on RDT performance in pregnant women with declining malaria transmission.

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Diagnostic performance of an ultrasensitive HRP2-based malaria rapid diagnostic test kit used in surveys of afebrile people living in Southern Ghana

Malaria Journal ◽

10.1186/s12936-021-03665-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Festus K. Acquah ◽

Dickson Donu ◽

Evans K. Obboh ◽

Dorcas Bredu ◽

Bernice Mawuli ◽

...

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Diagnostic Performance ◽

Venous Blood ◽

Malaria Rapid Diagnostic Test ◽

Treatment Interventions ◽

Enhanced Sensitivity ◽

Test Kit ◽

Blood Smears ◽

Study Participants

Abstract Background The Alere™ Malaria Ag P.f Ultra-sensitive RDT (UsmRDT) kit is an HRP2-based malaria rapid diagnostic test (RDT) with enhanced sensitivity relative to the SD Bioline Malaria Ag P.f RDT (mRDT) kit. However, the diagnostic performance of the UsmRDT kit has not been evaluated in Ghana. Methods A total of 740 afebrile participants aged between 3 and 88 years old were recruited from the Central and Greater Accra Regions of Ghana during the off-peak malaria season. Axillary body temperature was measured, and a volume of 1 ml venous blood was drawn from each participant. Prior to separating the blood into plasma and packed cell pellets via centrifugation, the blood was spotted onto one UsmRDT and one mRDT kit and also used to prepare thick and thin blood smears as well as filter paper blood spots. Plasmodium falciparum specific polymerase chain reaction (PCR) was performed on gDNA extracted from 100 µl of the whole blood. Results The overall positivity rate for microscopy, PCR, UsmRDT and mRDT kit were 20.4%, 40.8%, 31.3% and 30.8%, respectively. Overall, the UsmRDT identified 9.3% (28/302) more PCR positive samples than the mRDT kits. All samples that were negative by the UsmRDT kit were also negative by the mRDT kit. Overall, the sensitivity and specificity of the UsmRDT was 73% (221/302) and 89% (388/436), respectively, while that for the mRDT kit was 58% and 90%, respectively. Conclusion Although the UsmRDT kit was not as sensitive as PCR at detecting asymptomatic P. falciparum carriage, it correctly identified P. falciparum in 9.3% of the study participants that were not captured by the mRDT kit. In malaria endemic settings, the UsmRDT would provide an added advantage by identifying more asymptomatic P. falciparum carriers than the mRDT kit for targeted treatment interventions.

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Evaluating access to Malaria Rapid Diagnostic Test kit and Artemisinin-based Combination Therapy and the Quality of Treatment Practice among Over-the-Counter Medicine Sellers at the District Level in the Brong Ahafo Region - Ghana

TEXILA INTERNATIONAL JOURNAL OF CLINICAL RESEARCH ◽

10.21522/tijcr.2014.05.01.art001 ◽

2018 ◽

Vol 5 (1) ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Stephen Joseph Atta Mensah

Keyword(s):

Combination Therapy ◽

Diagnostic Test ◽

Rapid Diagnostic Test ◽

District Level ◽

Malaria Rapid Diagnostic Test ◽

Over The Counter ◽

Treatment Practice ◽

Test Kit ◽

Brong Ahafo Region

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Evaluation of the VIKIA Malaria Ag Pf/Pan malaria rapid diagnostic test in a non-endemic setting

10.26226/morressier.56d6be7cd462b80296c96113 ◽

2016 ◽

Author(s):

Sandrine Houze

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Malaria Rapid Diagnostic Test ◽

Endemic Setting

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Malaria rapid diagnostic test (HRP2/pLDH) positivity, incidence, care accessibility and impact of community WASH Action programme in DR Congo: mixed method study involving 625 households

Malaria Journal ◽

10.1186/s12936-021-03647-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Nlandu Roger Ngatu ◽

Basilua Andre Muzembo ◽

Nattadech Choomplang ◽

Sakiko Kanbara ◽

Roger Wumba ◽

...

Keyword(s):

Action Research ◽

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Mixed Method ◽

Malaria Incidence ◽

Control Site ◽

Malaria Rapid Diagnostic Test ◽

Post Intervention ◽

Referral Hospitals ◽

Action Programme

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. Results Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2–29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were predictors of household malaria. Conclusion This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.

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Clinical overlap between malaria and pneumonia: can malaria rapid diagnostic test play a role?

The Journal of Infection in Developing Countries ◽

10.3855/jidc.945 ◽

2011 ◽

Vol 5 (03) ◽

pp. 199-203 ◽

Cited By ~ 10

Author(s):

Kingsley Nnanna Ukwaja ◽

Olufemi B Aina ◽

Ademola A Talabi

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Diagnostic Tests ◽

Health Centre ◽

Rapid Diagnostic Tests ◽

Case Definition ◽

Sub Saharan Africa ◽

Malaria Rapid Diagnostic Test ◽

Chi Square ◽

Symptom Overlap

Introduction: Malaria and pneumonia account for 40% of mortality among children under five years of age in sub-Saharan Africa. Due to lack of diagnostic facilities, their management is based on the integrated management of childhood illnesses (IMCI) strategy. Symptoms of malaria and pneumonia overlap in African children, necessitating dual IMCI classifications at health centres and treatment with both antibiotics and antimalarials. This study determined the prevalence of malaria-pneumonia symptom overlap and confirmed the diagnosis of malaria in these cases using a rapid diagnostic test. Methodology: Consecutive consultations of 1,216 children (two months to five years old) were documented over a three-month period in a comprehensive health centre. Malaria rapid diagnostic tests were conducted only for children who had symptom overlap. Results: Of the 1,216 children enrolled, 1,090 (90%) reported cough or fever. Among the children fulfilling the malaria case definition, 284 (30%) also met the pneumonia case definition. Twenty-three percent (284) of all children enrolled met the criteria for both malaria and pneumonia. However, only 130 (46%) of them had a positive result for malaria using a malaria rapid diagnostic test. During a malaria-pneumonia overlap, female children (chi-square 5.9, P = 0.01) and children ≥ one year (chi-square 4.8, P = 0.003) were more likely to seek care within two days of fever. Conclusion: Dual treatment with antimalarials and antibiotics in children with malaria-pneumonia overlap may result in unnecessary over-prescription of antimalarial medications. Use of rapid diagnostic tests in their management can potentially avoid over-prescribing of malaria medications.

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