Comparison of three antigen detection tests for diagnosis and follow-up of falciparum malaria in travellers returning to Berlin, Germany

Abstract

We determined the sensitivity and specificity of three rapid immunochromatographic malarial antigen detection test systems (RDTs) for the detection of Plasmodium falciparum and assessed the quality of follow-up results. ParaSight-F and ICT Malaria detect histidinerich protein-2 (HRP-2), whereas OptiMal detects plasmodial lactate dehydrogenase (pLDH). ParaSight-F performed with 95.1% sensitivity and 97.1% specificity (554 patients tested of whom 144 had falciparum malaria). ICT Malaria performed with 95.7% sensitivity and 99.2% specificity (718 patients tested of whom 184 had falciparum malaria). OptiMal performed with 76.2% sensitivity and 99.7% specificity (539 patients tested of whom 130 had falciparum malaria). In follow-up investigations, HRP-2 did not appear to be a useful antigen due to its long half-life, whereas pLDH offers a reasonable correlation with the presence of viable parasites in those cases initially detected. We therefore conclude that a combination of both antigens might be the best option for creating a reliable RDT for the diagnosis of falciparum malaria.

Performance of “VIKIA Malaria Ag Pf/Pan” (IMACCESS®), a new malaria rapid diagnostic test for detection of symptomatic malaria infections

“…Using these reading times, the performance of the VIKIA Malaria Ag Pf/Pan™ test was similar to those of the CareStart Malaria™ test or those found in previous studies [21-26]. …”

Laboratory Diagnosis of Malaria: Comparison of Manual and Automated Diagnostic Tests

“…The sensitivity is comparable with an earlier study by Bharti et al [23] on First Response Malaria (sensitivity: 93%). On the other hand the sensitivity for ICT Malaria Combo was found to be lower (90.83%; 95% CI: 86.83–94.83) than the reported value of 95.7% by Grobusch et al [9] (Table 2). …”

Performance of pfHRP2 versus pLDH antigen rapid diagnostic tests for the detection of Plasmodium falciparum : a systematic review and meta-analysis

“…Most studies enrolled a consecutive or random sample of eligible patients, but in one study the procedure of patient enrollment was not clearly described [20]. Three studies were considered to be inappropriate because the studies excluded severe or special patients (such as pregnant women) from the studies [20–22]. Seven studies did not supply sufficient information about the blindness of index or reference standard tests [4, 6–8, 16, 22, 23].…”

“…Seven studies did not supply sufficient information about the blindness of index or reference standard tests [4, 6–8, 16, 22, 23]. Four studies reported that the tests were not performed or the results were missed in a portion of the patients [14, 20, 24, 25]. According to the criteria of the evaluation, 75% of studies had a low risk of bias in the patient selection domain, 50% of studies were judged to have low risk in the other 3 domains, and only 1 study was assessed to be at high risk of bias in patient selection and flow and timing domains [20].…”

“…Four studies reported that the tests were not performed or the results were missed in a portion of the patients [14, 20, 24, 25]. According to the criteria of the evaluation, 75% of studies had a low risk of bias in the patient selection domain, 50% of studies were judged to have low risk in the other 3 domains, and only 1 study was assessed to be at high risk of bias in patient selection and flow and timing domains [20]. In the applicability section, only 1 study was evaluated as high concern in the patient selection domain [15].…”