Performance comparison of CareStart™ HRP2/pLDH combo rapid malaria test with light microscopy in north-western Tigray, Ethiopia: a cross-sectional study

Feleke, Daniel Getacher; Tarko, Shambel; Hadush, Haftom

doi:10.1186/s12879-017-2503-9

Cited by 34 publications

(47 citation statements)

References 24 publications

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“…Furthermore, high positive predictive value (84%) revealed a low false positive rate by pfHRP2 RDT. These findings are in line with previous studies conducted at Ethiopia [32], Kenya [33] and Ghana [34]. However, when compare to qPCR, the P. falciparum positivity rate of pfHRP2 RDT was much lower (33.5%; 136/405).…”

Section: Discussionsupporting

confidence: 90%

Performance of PfHRP2 and PfPLDH Rapid Diagnostics Test for Diagnosis of Plasmodium falciparum in Assosa Zone, Northwest Ethiopia

Alemayehu¹,

López²,

Dieng³

et al. 2020

Preprint

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Background Malaria is a life-threatening infectious disease particularly due to Plasmodium falciparum (P.falciparum ). Plasmodium falciparum Histidine-Rich Protein 2 (PfHRP-2) and Plasmodium falciparum specific Lactate Dehydrogenase (PfPLDH) based rapid diagnostic test are commonly used for malaria diagnosis in malaria endemic countries where microscopic examination is scarce. However, there is limited information on the performance of malaria RDT in rural and semi urban area of Assosa zone, Northwest Ethiopia. Thus, the aim of this study is to determine the performance of PfHRP2 and PfPLDH RDT for diagnosis of falciparum malaria against microscopy as reference method. Methods Health-facility based cross-sectional study design was conducted in Assosa zone, Northwest Ethiopia from November to December 2018. A total of four hundred and six malaria-suspected participants attending Bambasi, Sherkole, Kurmuk and Assosa health-centers were tested. Finger-prick blood samples were collected for microscopy blood film preparation, RDTs and molecular diagnosis. Statistical analyses were performed using SPSS version 20. Results Of the total study participants, 26.4% (107/406) were microscope confirmed P. falciparum positive. Using PfHRP2 and PfPLDH RDT, 30.3% (123/406) and 24.1% (98/406) were positive for P. falciparum, respectively. The sensitivity of PfHRP2 and PfPLDH was 96% and 89%, respectively, against microscope. The corresponding specificity rates of PfHRP2 and PfPLDH were 93% and 99%, respectively. Similarly, positive predictive value (PPV) and negative predictive value of PfHRP2 and PfPLDH RDT were 84%, 97%, 99% and 96%, respectively. There was an agreement between RDTs (PfPLDH and PfHRP2) and reference microscopy method with a kappa value of 0.86 and 0.90, respectively. Compared to qPCR, the specificity of PfHRP2 (93%) and PfPLDH RDT (98%) were high, though the respective sensitivity of PfHRP2(77%) and PfPLDH RDT(70%) were low. Conclusion PfHRP2 and PfPLDH showed reasonable agreement in detecting P. falciparum infections. Hence, currently used national malaria RDT kit can be continue to be used in certain malaria endemic areas in Ethiopia. However, Continuous monitoring the performance of PfHRP-2 RDT associated with false negative results is important to consider an alternative malaria RDT like PfPLDH RDT to support control and elimination of malaria in Ethiopia

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Section: Discussionsupporting

confidence: 90%

Performance of PfHRP2 and PfPLDH Rapid Diagnostics Test for Diagnosis of Plasmodium falciparum in Assosa Zone, Northwest Ethiopia

Alemayehu¹,

López²,

Dieng³

et al. 2020

Preprint

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“…Hence, microscopy and RDTs continue to be the primary choices for diagnosing malaria in most endemic countries. Microscopy is still considered the "gold standard" for malaria diagnosis in endemic countries because has a sensitivity of 50-500 parasites/μl [7], is inexpensive, and allows the identification of species and parasite density [8,9], however the implementation of microscopy as diagnosis tool, especially in remote areas has been reported to be cumbersome and to requires trained personnel, microscopes and a source of electricity [10]. In remote areas of sub-Saharan Africa, RDTs have become the primary tool for the parasitological diagnosis or confirmation of malaria [11].The most widely used RDTs for malaria are based on the detection of parasite histidine-rich protein II (HRP2) and Plasmodium lactate dehydrogenase (pLDH) [12].…”

Section: Introductionmentioning

confidence: 99%

A comparative assessment of Rapid Diagnosis Test (RDT) versus microscopy for malaria diagnosis in health care facilities

Njuabe

Fru

FonGah

et al. 2020

Preprint

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Background: Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The objective of this study was to determine the best approach on malaria diagnosis in detection of malaria parasite in the Northwest region, of Cameroon among different population groups. Materials and method: The cross sectional study was conducted on 60 febrile patients who were directed to the laboratory department for blood screening at the Bamenda Regional Hospital after showing signs and symptoms of malaria infection. Blood sample were collected aseptically and dispensed into an EDTA container where RDTs and microscopic examination were performed to assess the presence of malaria parasites. Results from the rapid diagnostic kits were analyzed and compared to those obtained by general microscopy. Results : Of the 60 samples enrolled 37 (61.7%) were found to be positive with blood films examination while in rapid diagnostic test 27 (45%) were positive. Based on frequency of infection by age 20-35 years had 13 (35.1%) as the most vulnerable group, followed by 0 -5 year with 11 (29.7%), 6-19 had 6 (16.2%) while age group of 36-59 had 5 (16.0%) and lastly the age group of 60 and above had least value of 2 (5.4%). The prevalence of malaria obtained through microscopy (62%) was significantly higher than in RDT (45%). Considering microscopy as the gold standard, RDT exhibited high specificity (100%) and sensitivity (73%) with positive predictive and negative predictive values of 100% and 70%, respectively. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia which was the plasmodium specie detected in all positive cases. Conclusion: The study, therefore, highlights that the routine microscopy test demonstrated a superior sensitivity compared to RDT method of malaria diagnosis, however, RDT could be a useful tool in individuals suspected to show high degree of disease spectrum for quick intervention in order to avert danger associated with delayed diagnosis.

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“…Approximately, 75% of the landmass of Ethiopia is estimated to be "malarious" with about 52 million people living in these areas and about four to five million people affected by malaria annually. Plasmodium falciparum and Plasmodium vivax account for 60-70% and 30-40% of cases, respectively [12][13][14]. In Ethiopia, early diagnosis and prompt treatment is considered as key strategy for malaria control.…”

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confidence: 99%

Asymptomatic malaria infection among pregnant women attending antenatal care in malaria endemic areas of North-Shoa, Ethiopia: a cross-sectional study

Feleke

Adamu

Gebreweld

et al. 2020

Malar J

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Background: The effort to reduce the burden of malaria should target transmission in the community by accurate identification of asymptomatic infections. In malaria-endemic areas, asymptomatic malaria infection is still associated with complications. Malaria during pregnancy is characterized by anaemia and placental malaria, leading to low birth weight and perinatal morbidity and mortality. This study aimed to provide reliable data on the burden of asymptomatic malaria among pregnant women in malaria endemic areas of North-Shoa, Ethiopia. Methods: Cross-sectional study was carried out to assess the prevalence and predictors of asymptomatic malaria in pregnant women from November 2018 to January 2019. Multistage sampling technique was employed to include 263 study participants. Data were analysed using SPSS version 20.0 statistical software. In all comparisons, p-values ≤ 0.05 was considered as statistically significant. Results: The prevalence of asymptomatic malaria infection was 5.7% (15/263) and 3.4% (9/263) by using microscopy and RDTs, respectively. Plasmodium falciparum was a dominant species 9 (3.4%) and Plasmodium vivax accounted for 6 (2.3%) of Plasmodium infections as detected by microscopy. Multivariate analysis showed that ITN usage and haemoglobin level had a statistically significant association with Plasmodium infection after adjusting other possible factors. Compared to those who were using ITN always, the odds of Plasmodium infection was 18.16 times higher (95% CI 1.84-179.07) in pregnant women who were not using ITN, and 5.19 times higher (95% CI 0.55-49.21) in pregnant women who were using ITN sometimes. Asymptomatic malaria infected pregnant women were 3.78 times (95% CI 0.98-14.58) more likely to be anaemic compared to non-infected pregnant women. Conclusion: The present study showed asymptomatic malaria is prevalent in pregnant women and it has statistically significance association with the haemoglobin level of pregnant women. This indicates pregnant women have to be screened for asymptomatic malaria to avoid health consequences of malaria infection during pregnancy for the mother and fetus.

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Performance comparison of CareStart™ HRP2/pLDH combo rapid malaria test with light microscopy in north-western Tigray, Ethiopia: a cross-sectional study

Cited by 34 publications

References 24 publications

Performance of PfHRP2 and PfPLDH Rapid Diagnostics Test for Diagnosis of Plasmodium falciparum in Assosa Zone, Northwest Ethiopia

Performance of PfHRP2 and PfPLDH Rapid Diagnostics Test for Diagnosis of Plasmodium falciparum in Assosa Zone, Northwest Ethiopia

A comparative assessment of Rapid Diagnosis Test (RDT) versus microscopy for malaria diagnosis in health care facilities

Asymptomatic malaria infection among pregnant women attending antenatal care in malaria endemic areas of North-Shoa, Ethiopia: a cross-sectional study

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