Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly.
| Published in | Central African Journal of Public Health (Volume 7, Issue 4) |
| DOI | 10.11648/j.cajph.20210704.12 |
| Page(s) | 159-163 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Malaria, Performance, Rapid Diagnostic Test, HRP2-based Test, Kinsantu Health Zone
| [1] | Organization WH. World Malaria Report 2020. Geneva 2020. 2020. |
| [2] | Organization WH. Guidelines for the treatment of malaria; Geneva. 2010.. |
| [3] | Paludisme PNdLcl. Plan Stratégique National de Lutte contre le Paludisme 2016-2020. 2016. |
| [4] | Gillon Ilombe VM, Hypolite Muhindo Mavoko, Raquel Inocencio da Luz, Pascal Lutumba, Jean-Pierre Van geertruyden.. Performance of HRP2-based rapid test in children attending the health center compared to asymptomatic children in the community. Malaria Journal 2014 9. 2014; 13: 308. |
| [5] | Swarthout TD CH, Senga RK, Van den Broek I. Paracheck-PfR accuracy and recently treated Plasmodium falciparum infections: is there a risk of over-diagnosis? Malar J 2007. 2007; 6: 58. |
| [6] | A-Elgayoum SME E-KA, El-Feki A, Mahgoub BA, El-Rayah E-A, Giha HA. Malaria overdiagnosis and burden of malaria misdiagnosis in the suburbs of central Sudan: special emphasis on artemisinin-based combination therapy era.. Diagnostic Microbiology and Infectious Disease 2009. 2009; 64: 20-6. |
| [7] | Abeku TA KM, Jones C, Beard J, Mueller DH, Okia M. Determinants of the accuracy of rapid diagnostic tests in malaria case management: evidence from low and moderate transmission settings in the East African highlands. Malaria Journal 2002.7: 202. |
| [8] | V D. Relative utility of dipsticks for diagnosis of malaria in mesoendemic area for Plasmodium falciparum and P. vivax in Northeastern India. Vector-Borne and Zoonotic Diseases 2004. 2004; 4 (2): 123–30. |
| [9] | Mens P SN, Omar S, Heijnen M, Schallig H, Kager PA. Is molecular biology the best alternative for diagnosis of malaria to microscopy? A comparison between microscopy, antigen detection and molecular tests in rural Kenya and urban Tanzania.. Tropical Medicine and International Health 2007. 2007; 12 (2): 238–44. |
| [10] | Hopkins H BL, Kambales W, Dokomajilar C, Rosenthal PJ, Dorsey G. Rapid diagnostic tests for malaria at sites of varying transmission intensity in Uganda. The Journal of Infectious Diseases 2008. 2008; 197: 510–8. |
| [11] | Gerstl S DS, Mukhtar A, De Smet M, Baker A, Maikers J.. Assessment of two malaria rapid diagnostic tests, with follow-up of positive pLDH test results, in a hyperendemic falciparum malaria area. Tropical Medicine and International Health 2009. 2009; 14 (Suppl 2): 92. |
| [12] | De Oliveira AM SJ, Ouma P, Kariuki S, Barnwell J, Otieno K, et al. Malaria rapid diagnostic test use and performance by facility-based health workers in western Kenya. American Journal of Tropical Medicine and Hygiene 2007. 2007; 77: 338. |
| [13] | De Oliveira AM SJ, Ouma PO, Kariuki S, Barnwell JW, Otieno K, et al. Performance of malaria rapid diagnostic tests as part of routine malaria case management in Kenya. American Journal of Tropical Medicine and Hygiene 2009. 2009; 80 (3): 470–4. |
| [14] | Parr JB VR, Doctor SM, Janko M, Carey-Ewend K, Turman BJ, Keeler C, Slater HC, Whitesell AN, Mwandagalirwa K, Ghani AC, Likwela JL, Tshefu AK, Emch M, Juliano JJ, Meshnick SR.. Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey. J Infect Dis 2017 Jul 1. 2017; 216 (1): 36-44. |
| [15] | Lee JH JJ, Cho CH, Kim JY, Han ET, Yun SG, et al. False-positive results for rapid diagnostic tests for malaria in patients with rheumatoid factor. Journal of clinical microbiology. 2014; 52 (10): 3784-7. |
| [16] | Tate J WG. Interferences in immunoassay. Clin Biochem Rev 2004. 2004; 25 (2): : 105-20. |
| [17] | Haberichter KL JP, Chittick PJ, Millward P, Robinson-Dunn B, Boyanton BL, Jr. The Brief Case: False-Positive Rapid Malaria Antigen Test Result in a Returned Traveler.. Journal of clinical microbiology. 2017; 55 (8): 2294-7. |
| [18] | Chansuda Wongsrichanalai MJB SM, Awalludin Sutamihardja, and Walther H. Wernsdorfer. A Review of Malaria Diagnostic Tools: Microscopy and Rapid Diagnostic Test (RDT). In: Breman JG AM, White NJ, editor. Defining and Defeating the Intolerable Burden of Malaria III: Progress and Perspectives. American Journal of Tropical Medicine and Hygiene 2007; 77 (6). |
| [19] | Hypolite Mavoko Muhindo GI, Ruth Meya, Patrick M Mitashi, Albert Kutekemeni, Didier Gasigwa, Pascal Lutumba, Jean-Pierre Van Geertruyden. Accuracy of malaria rapid diagnosis test Optimal-IT® in Kinshasa, the Democratic Republic of Congo. Malar J 2012. 2012; 11: 224. |
| [20] | Koram KA MM. When is "malaria" malaria? The different burdens of malaria infection, malaria disease, and malaria-like illnesses. The American journal of tropical medicine and hygiene. 2007; 77 (6 Suppl): 1-5. |
| [21] | Bell DR WD, Martin LB. False-positive results of a Plasmodium falciparum histidine-rich protein 2-detecting malaria rapid diagnostic test due to high sensitivity in a community with fluctuating low parasite density.. The American journal of tropical medicine and hygiene. 2005; 73 (1): 199-203. |
| [22] | Wellems TE W-JA, Panton LJ. Genetic mapping of the chloroquine-resistance locus on Plasmodium falciparum chromosome 7.. Proceedings of the National Academy of Sciences of the United States of America 1991; 88 (8): 3382-6. |
| [23] | Biswas S TD, Rao DN.. Investigation of the kinetics of histidine-rich protein 2 and of the antibody responses to this antigen, in a group of malaria patients from India. Annals of tropical medicine and parasitology. 2005; 99 (6): 553-62. |
APA Style
Gillon Ilombe, Sylvie Linsuke, Aimé Lulebo, Joris Likwela, Paulin Mutombo, et al. (2021). Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Central African Journal of Public Health, 7(4), 159-163. https://doi.org/10.11648/j.cajph.20210704.12
ACS Style
Gillon Ilombe; Sylvie Linsuke; Aimé Lulebo; Joris Likwela; Paulin Mutombo, et al. Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Cent. Afr. J. Public Health 2021, 7(4), 159-163. doi: 10.11648/j.cajph.20210704.12
AMA Style
Gillon Ilombe, Sylvie Linsuke, Aimé Lulebo, Joris Likwela, Paulin Mutombo, et al. Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Cent Afr J Public Health. 2021;7(4):159-163. doi: 10.11648/j.cajph.20210704.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.cajph.20210704.12,
author = {Gillon Ilombe and Sylvie Linsuke and Aimé Lulebo and Joris Likwela and Paulin Mutombo and Pascal Lutumba and Jean-Pierre Van Geertruyden Rika Matangila and Junior Rika Matangila},
title = {Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo},
journal = {Central African Journal of Public Health},
volume = {7},
number = {4},
pages = {159-163},
doi = {10.11648/j.cajph.20210704.12},
url = {https://doi.org/10.11648/j.cajph.20210704.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20210704.12},
abstract = {Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly.},
year = {2021}
}
TY - JOUR T1 - Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo AU - Gillon Ilombe AU - Sylvie Linsuke AU - Aimé Lulebo AU - Joris Likwela AU - Paulin Mutombo AU - Pascal Lutumba AU - Jean-Pierre Van Geertruyden Rika Matangila AU - Junior Rika Matangila Y1 - 2021/06/21 PY - 2021 N1 - https://doi.org/10.11648/j.cajph.20210704.12 DO - 10.11648/j.cajph.20210704.12 T2 - Central African Journal of Public Health JF - Central African Journal of Public Health JO - Central African Journal of Public Health SP - 159 EP - 163 PB - Science Publishing Group SN - 2575-5781 UR - https://doi.org/10.11648/j.cajph.20210704.12 AB - Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly. VL - 7 IS - 4 ER -
Information
Email: