An Update on Malaria Rapid Diagnostic Tests

Mukkala, Avinash N.; Kwan, Jason C.; Lau, Rachel; Harris, David; Kain, Dylan; Boggild, Andrea K.

doi:10.1007/s11908-018-0655-4

Cited by 65 publications

(51 citation statements)

References 31 publications

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“…The currently available malaria rapid diagnostic tests (RDTs) come in various formats and contain antibodies targeted to three parasite antigens: Plasmodium falciparum-specific histidine-rich protein 2 (PfHRP2) and two enzymes in the plasmodial glycolytic pathway, lactate dehydrogenase (pLDH) and aldolase, in various combinations. 1,2 The monoclonal antibodies (mAbs) used against PfHRP2 can recognize the paralog gene product PfHRP3, which has a sequence homology of more than 75% in the tandem repeat region to PfHRP2. 3,4 In parasites having pfhrp2 deletion, recognition of PfHRP3 could enhance the sensitivity of the PfHRP2detecting RDTs.…”

Section: Introductionmentioning

confidence: 99%

Plasmodium falciparum Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar

Mehlotra

Howes

Cramer

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Current malaria rapid diagnostic tests (RDTs) contain antibodies against Plasmodium falciparum-specific histidine-rich protein 2 (PfHRP2), Plasmodium lactate dehydrogenase (pLDH), and aldolase in various combinations. Low or high parasite densities/target antigen concentrations may influence the accuracy and sensitivity of PfHRP2-detecting RDTs. We analyzed the SD Bioline Malaria Ag P.f/Pan RDT performance in relation to P. falciparum parasitemia in Madagascar, where clinical Plasmodium vivax malaria exists alongside P. falciparum. Nine hundred sixty-three samples from patients seeking care for suspected malaria infection were analyzed by RDT, microscopy, and Plasmodium species-specific, ligase detection reaction-fluorescent microsphere assay (LDR-FMA). Plasmodium infection positivity by these diagnostics was 47.9%, 46.9%, and 58%, respectively. Plasmodium falciparum-only infections were predominant (microscopy, 45.7%; LDR-FMA, 52.3%). In all, 16.3% of P. falciparum, 70% of P. vivax, and all of Plasmodium malariae, Plasmodium ovale, and mixed-species infections were submicroscopic. In 423 P. falciparum mono-infections, confirmed by microscopy and LDR-FMA, the parasitemia in those who were positive for both the PfHRP2 and pan-pLDH test bands was significantly higher than that in those who were positive only for the PfHRP2 band (P < 0.0001). Plasmodium falciparum parasitemia in those that were detected as P. falciparum-only infections by microscopy but P. falciparum mixed infections by LDR-FMA also showed similar outcome by the RDT band positivity. In addition, we used varying parasitemia (3-0.0001%) of the laboratory-maintained 3D7 strain to validate this observation. A positive pLDH band in high P. falciparum-parasitemic individuals may complicate diagnosis and treatment, particularly when the microscopy is inconclusive for P. vivax, and the two infections require different treatments.

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Section: Introductionmentioning

confidence: 99%

Plasmodium falciparum Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar

Mehlotra

Howes

Cramer

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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“…This may be because two rapid diagnostic tests (Pf/pan, by Wondfo and by ACCESSBIO) that are highly sensitive to P. falciparum, but are insensitive to P. ovale spp. [29,30], have been used to provide parasite-based diagnosis in Anhui province since 2013. If P. ovale spp.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Zhang

Wang

Wang³

et al. 2020

Preprint

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Background Although autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69% in 2015 and 19.35% in 2018. Methods We conducted a case-based retrospective study, using data collected from the China Information System for Disease Control and Prevention and Information System for Parasitic Disease Control and Prevention from 2012–2019, to describe the trends and differences between P. o. curtisi and P. o. wallikeri. Epidemiological characteristics were analyzed using descriptive statistics. Results P. ovale curtisi and P. ovale wallikeri were found simultaneously circulating in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of mixed infection cases was 10.16%. Six cases of co-infection by P. ovale and P. falciparum were observed, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved in only 20.00% of cases with P. ovale infection. At the reporting units, 32.17% and 6.96% of P. ovale spp. cases were misdiagnosed as P. vivax and P. falciparum, respectively. Conclusion Our finding indicates that the ability of P. ovale spp. to co-infect with other malarial species has been previously underestimated and providing rational evidence for the existence of hypnozoites in P. ovale spp. P. o. curtisi and P. o. wallikeri circulate simultaneously in Africa, and the incidence of P. ovale spp. is probably also underestimated in these source countries where the disease is endemic. Given the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp., and introduced in non-endemic areas.

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“…Other innovate methods of diagnosis in the DMS include a malaria rapid antigen detection test kit, which is portable and can be done at the bedside in role 1 facilities. While not as sensitive or specific as expert microscopy, the technology is improving in accuracy, and other strains of malaria are now detectable 31. Such portable and inexpensive tests may well prove useful in resource-poor and austere environments.…”

Section: Diagnosismentioning

confidence: 99%

Communicable diseases in humanitarian operations and disasters

Murphy¹

2020

BMJ Mil Health

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Military organisations have battled communicable disease for millennia. They have pioneered disease prevention from the Crusades to the World Wars and continue to do so today. Predeployment vaccinations and chemoprophylaxis are effective in preventing communicable disease, as is reliable vector destruction and bite prevention, especially in the era of multidrug resistant organisms. These measures are unlikely to be fully possible in disasters, but reactive vaccination and efforts to reduce exposure to communicable disease should be a priority. Communicable diseases can be challenging to diagnose—the UK Defence Medical Services have become familiar with tools such as multiplex PCR and mass spectrometry. These have the potential to accurately identify organisms and sensitivity patterns in austere environments. Management of communicable diseases depends on accurate diagnosis and has a largely well-established evidence base but can be limited by a lack of resources and skills in an austere setting, therefore telemedicine can assist diagnosis and treatment of infections by projecting specialist skill. Systems such as EpiNATO2 are useful in monitoring diseases and identifying trends in order to establish control measures. Many of these tools and techniques are effective in austere environments and offer learning opportunities for those providing care in similar settings. Further research is ongoing into diagnostic tools as well as remote management.

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An Update on Malaria Rapid Diagnostic Tests

Cited by 65 publications

References 31 publications

Plasmodium falciparum Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar

Plasmodium falciparum Parasitemia and Band Sensitivity of the SD Bioline Malaria Ag P.f/Pan Rapid Diagnostic Test in Madagascar

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Communicable diseases in humanitarian operations and disasters

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