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




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Malaria Journal

, 15:496

First Online: 04 October 2016Received: 28 June 2016Accepted: 09 September 2016DOI: 10.1186-s12936-016-1529-6

Cite this article as: Grandesso, F., Nabasumba, C., Nyehangane, D. et al. Malar J 2016 15: 496. doi:10.1186-s12936-016-1529-6

Abstract

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

KeywordsMalaria Fever Diagnostic Rapid diagnostic test Sensitivity Specificity Performance Negativity Electronic supplementary materialThe online version of this article doi:10.1186-s12936-016-1529-6 contains supplementary material, which is available to authorized users.

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Autor: Francesco Grandesso - Carolyn Nabasumba - Dan Nyehangane - Anne-Laure Page - Mathieu Bastard - Martin De Smet - Yap Boum -

Fuente: https://link.springer.com/







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