Failure of the ‘pan-malarial’ antibody of the ICT Malaria P.f/P.v® immunochromatographic test to detect symptomatic Plasmodium malariae infection

Dyer, Mary E.; Tjitra, Emiliana; Currie, Bart J.; Anstey, Nicholas M.

doi:10.1016/s0035-9203(00)90072-5

Cited by 25 publications

(13 citation statements)

References 4 publications

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“…Plasmodium vivax can also be detected by detection of antibodies against pan-malarial antigen in the absence of those against HRP-2 (ICT Malaria Pf/Pv). [12][13][14][15] The sensitivity and specificity of each of these tests have been assessed in a range of clinical situations.…”

Section: Introductionmentioning

confidence: 99%

Performance of the Optimal Test for Malaria Diagnosis Among Suspected Malaria Patients at the Rural Health Centers

Iqbal

Muneer

Khalid

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Abstract. The OptiMAL test detects both Plasmodium falciparum and P. vivax malaria infections. In this study, we evaluated the performance of the OptiMAL test at the Basic Health Units (BHUs) and the District Health Quarter (DHQ) Center in rural villages of Punjab, Pakistan that provide minimal health services. Two sets of blood specimens obtained from 930 suspected malaria patients attending these BHUs were tested at BHUs and the DHQ Center by microscopy and the OptiMAL test. At the BHUs, 231 (25%) of the patients were positive by microscopy and 278 (30%) patients tested positive by the OptiMAL test. At the DHQ Center, microscopic analysis of a second set of specimens from the same patients confirmed the malaria infection in 386 (42%) patients and the OptiMAL test result was positive in 300 (32%) patients. To determine the performance of OptiMAL test at the BHUs and the DHQ Center, all data were compared with microscopy results obtained at the DHQ Center. The OptiMAL test results for P. falciparum at the BHUs were comparable to those of the OptiMAL test at the DHQ Center. However, the sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of the OptiMAL test were considerably lower for P. vivax infections than for P. falciparum infections, irrespective of whether the test was performed at the BHUs or at the DHQ Center (P. falciparum: sensitivity ‫ס‬ 78-85%, PPV ‫ס‬ 89-97%, NPV ‫ס‬ 96-98%; P. vivax: sensitivity ‫ס‬ 61-76%, PPV ‫ס‬ 88-95%, NPV ‫ס‬ 90-93%). The OptiMAL test also detected a number of false-positive and false-negative results at both the BHUs and the DHQ Center. The false-positive results ranged from 1% to 2%; however, the number of false-negative results was much higher (BHUs: P. falciparum ‫ס‬ 22%, P. vivax ‫ס‬ 39%; DHQ Center: P. falciparum ‫ס‬ 15%, P. vivax ‫ס‬ 24%). In conclusion, these results, when combined with other advantages of the OptiMAL test, suggest that this test can be used by relatively inexperienced persons to diagnose malaria infection in rural areas where facilities for microscopy are not available.

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Section: Introductionmentioning

confidence: 99%

Performance of the Optimal Test for Malaria Diagnosis Among Suspected Malaria Patients at the Rural Health Centers

Iqbal

Muneer

Khalid

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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“…Yet, the performance of both tests in the detection of Plasmodium ovale and Plasmodium malariae has been poor so far [4,5,6,7,8]. In order to provide more data on the accuracy and usefulness of these tests, the present study was conducted.…”

Section: Introductionmentioning

confidence: 99%

Rapid Immunochromatographic Malarial Antigen Detection Unreliable for Detecting Plasmodium malariae and Plasmodium ovale

Hänscheid

Zöller

et al. 2002

European Journal of Clinical Microbiology & Infectious Dise

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In order to determine the reliability of two commercial tests for the rapid detection of plasmodial antigen in cases of infection with Plasmodium ovale and Plasmodium malariae, the products were evaluated in four centers and a search of the relevant literature was performed. The results of the present and previous studies were compared. With overall sensitivities ranging between 18.8% and 47.6% for Plasmodium malariae and between 20% and 31.3% for Plasmodium ovale, it is evident that neither test is reliable for the detection of Plasmodium ovale and Plasmodium malariae infections.

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“…In the case of P. falciparum infection, these new rapid methods are based on detection of the histidine-rich protein 2 (HRP2; e.g., the ICT Malaria Pf, ParaSight-F, and ICT Malaria Pf/Pv tests) (1-6, 11, 20) or parasite lactate dehydrogenase (pLDH; e.g., OptiMAL-IT) (7-9, 11, 18-20). The sensitivities and specificities of each of these tests have been assessed in a range of clinical situations (1,2,5,7,11,19), although the overall sensitivity and specificity of all of these assays to detect P. falciparum infection is high (Ͼ90%). However, the sensitivity of these assays decreases to Ͻ70% in parasitemia Ͻ50/l.…”

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confidence: 99%

Persistent Histidine-Rich Protein 2, Parasite Lactate Dehydrogenase, and Panmalarial Antigen Reactivity after Clearance of Plasmodium falciparum Monoinfection

Iqbal

Ahmed²,

Jameel³

et al. 2004

J Clin Microbiol

117

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We tested 240 patients with Plasmodium falciparum monoinfection for persistent parasite antigenemia after successful standardized antimalarial therapy by using the ICT Malaria Pf/Pv and OptiMAL-IT assays that detect the malaria antigens Plasmodium falciparum histidine-rich protein 2 (HRP2) and parasite lactate dehydrogenase (pLDH), respectively, as well as a panmalarial antigen (PMA). The patients were screened for antigenemia on days 0, 3, 7, and 14 of follow-up. On day 0, all 240 patients showed positive reactivity with both assays. Of the 229 cases with negative parasitemia on day 3, persistent antigenemia was observed in 207 (90.4%) of the cases: 188 (82.1%) for HRP2 antigen and 75 (32.8%) for PMA. There was a gradual decrease in antigenemia on follow-up to day 14; however, the drop in reactivity to PMA was less than that for HRP2 antigen. In contrast to HRP2 antigenemia, there was a significant decrease in pLDH antigenemia to 38.4% and to 14.8% (PMA) on day 3 (P < 0.03). The pLDH antigenemia level dropped further to 14.8% on day 7. There was no significant association of persistent antigenemia with gametocytemia. One case with gametocytemia was negative for both the antigens. In conclusion, the OptiMAL-IT assay is more sensitive than the ICT Malaria Pf/Pv test for monitoring therapeutic responses after antimalarial therapy since the LDH activity ceases when the malarial parasite dies.Clinical diagnosis of malaria still relies upon identification of malaria parasites in Giemsa-stained blood smears of the peripheral blood. Recently, rapid diagnostic tests for the detection of Plasmodium falciparum infection has been introduced to overcome the problem of time constraints and low sensitivity in diagnosing malaria infections with a low level of parasitemia by microscopy. These rapid diagnostic tests are the immunochromatographic tests (ICT) based on the detection of antigen(s) released from the parasitized red blood cells. In the case of P. falciparum infection, these new rapid methods are based on detection of the histidine-rich protein 2 (HRP2; e.g., the ICT Malaria Pf, ParaSight-F, and ICT Malaria Pf/Pv tests) (1-6, 11, 20) or parasite lactate dehydrogenase (pLDH; e.g., OptiMAL-IT) (7-9, 11, 18-20). The sensitivities and specificities of each of these tests have been assessed in a range of clinical situations (1,2,5,7,11,19), although the overall sensitivity and specificity of all of these assays to detect P. falciparum infection is high (Ͼ90%). However, the sensitivity of these assays decreases to Ͻ70% in parasitemia Ͻ50/l. Further, these assays may remain positive due to persistence of P. falciparum HRP2 antigenemia after antimalarial therapy. This may result in a false-positive (FP) diagnosis of infection and thus may reduce the usefulness of the test in predicting treatment failure (4,11,12,19). FP reactions have been reported in individuals with a history of recent fever and antimalarial treatment due to persistent circulation of HRP2 for up to 2 weeks after clearance of parasites or in patients who had...

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Failure of the ‘pan-malarial’ antibody of the ICT Malaria P.f/P.v® immunochromatographic test to detect symptomatic Plasmodium malariae infection

Cited by 25 publications

References 4 publications

Performance of the Optimal Test for Malaria Diagnosis Among Suspected Malaria Patients at the Rural Health Centers

Performance of the Optimal Test for Malaria Diagnosis Among Suspected Malaria Patients at the Rural Health Centers

Rapid Immunochromatographic Malarial Antigen Detection Unreliable for Detecting Plasmodium malariae and Plasmodium ovale

Persistent Histidine-Rich Protein 2, Parasite Lactate Dehydrogenase, and Panmalarial Antigen Reactivity after Clearance of Plasmodium falciparum Monoinfection

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