Meta-Analysis: Accuracy of Rapid Tests for Malaria in Travelers Returning from Endemic Areas

Marx, Arthur; Pewsner, Daniel; Egger, Matthias; Nüesch, Reto; Bucher, Heiner C.; Genton, Blaise; Hatz, Christoph; Jüni, Peter

doi:10.7326/0003-4819-142-10-200505170-00009

Cited by 152 publications

(125 citation statements)

References 32 publications

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“…Studies evaluating other RDTs in non-endemic countries report similar sensitivities as those found for the CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test in the present study: for P. falciparum they ranged from 87.5-99.0%, with one exception of 76.2% [7,10,16-21]. For P. vivax , RDTs detecting pan-pLDH showed sensitivities of 33.5% and 62.0%-95.0%,[7,10,13,18,20,22] compared to 46.0%-93.0% [13] for those RDTs targeting aldolase. The increase of sensitivities at higher parasite densities is a well-known phenomenon with breakpoints around 100/μl ( P. falciparum ) and 500/μl ( P. vivax ) [7,10,13,22,23].…”

Section: Discussionsupporting

confidence: 84%

“…Previous studies that included P. ovale or P. malariae species reported sensitivities for these species combined between 36 - 95% for pan-pLDH and 7 - 80% for aldolase based RDTs [13]. In addition, a previous study with a study design similar to the present one reported sensitivities for P. ovale and P. malariae of 76.3% and 45.2% respectively [7].…”

Section: Discussionmentioning

confidence: 54%

“…However, it included exclusively P. falciparum samples with parasite densities above 100/μl, which is above the detection threshold of most RDTs. In addition, small differences may also be explained by the fact that we included P. falciparum samples with pure gametocytaemia as positive samples: in the scope of travel medicine this is a reasonable option [13], but in the present study five out of 17 samples did not react with the HRP-2 line and hence decreased overall sensitivity. Another product of the same company, the CareStart™ Malaria pLDH (Pf/pan) Combo Test has been evaluated in a field study in Madagascar [14].…”

Section: Discussionmentioning

confidence: 98%

“…For P. vivax , RDTs detecting pan-pLDH showed sensitivities of 33.5% and 62.0%-95.0%,[7,10,13,18,20,22] compared to 46.0%-93.0% [13] for those RDTs targeting aldolase. The increase of sensitivities at higher parasite densities is a well-known phenomenon with breakpoints around 100/μl ( P. falciparum ) and 500/μl ( P. vivax ) [7,10,13,22,23]. …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a rapid diagnostic test (CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test) for the diagnosis of malaria in a reference setting

Maltha

Gillet

Bottieau

et al. 2010

Malar J

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BackgroundMalaria Rapid Diagnostic Tests (RDTs) are widely used for diagnosing malaria. The present retrospective study evaluated the CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test targeting the Plasmodium falciparum specific antigen histidine-rich protein (HRP-2) and the pan-Plasmodium antigen lactate dehydrogenase (pLDH) in a reference setting.MethodsThe CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test was evaluated on a collection of samples obtained in returned international travellers using microscopy corrected by PCR as the reference method. Included were P. falciparum (n = 320), Plasmodium vivax (n = 76), Plasmodium ovale (n = 76), Plasmodium malariae (n = 23) and Plasmodium negative samples (n = 95).ResultsOverall sensitivity for the detection of P. falciparum was 88.8%, increasing to 94.3% and 99.3% at parasite densities above 100 and 1,000/μl respectively. For P. vivax, P. ovale and P. malariae, overall sensitivities were 77.6%, 18.4% and 30.4% respectively. For P. vivax sensitivity reached 90.2% for parasite densities above 500/μl. Incorrect species identification occurred in 11/495 samples (2.2%), including 8/320 (2.5%) P. falciparum samples which generated only the pan-pLDH line. For P. falciparum samples, 205/284 (72.2%) HRP-2 test lines had strong or medium line intensities, while for all species the pan-pLDH lines were less intense, especially in the case of P. ovale. Agreement between observers was excellent (kappa values > 0.81 for positive and negative readings) and test results were reproducible. The test was easy to perform with good clearing of the background.ConclusionThe CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test performed well for the detection of P. falciparum and P. vivax, but sensitivities for P. ovale and P. malariae were poor.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of a rapid diagnostic test (CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test) for the diagnosis of malaria in a reference setting

Maltha

Gillet

Bottieau

et al. 2010

Malar J

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show abstract

“…However, the Immunoquick+4 did not reach the 95% sensitivity for parasite densities >100/µl recommended by the WHO [17]. For P. vivax, MRDTs targeting pan-pLDH show sensitivities from 33.5% and 62.0-95.0% [3,12,15,[18][19][20], compared to 46.0-93.0% [20] [20]. Previously, we demonstrated for a three-band HRP-2/pan-pLDH MRDT in a study design similar to the present one sensitivities for P. ovale and P. malariae of 76.3 and 45.2%, respectively [3].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Immunoquick+4 malaria rapid diagnostic test in a non-endemic setting

Dijk

Gillet

Vlieghe

et al. 2010

Eur J Clin Microbiol Infect Dis

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The aim of this retrospective study was to evaluate the Immunoquick+4 (BioSynex, Strasbourg, France), a three-band malaria rapid diagnostic test (MRDT) targeting histidine-rich protein-2 (HRP-2) and pan Plasmodium-specific parasite lactate dehydrogenase, in a non-endemic reference setting. Stored whole-blood samples (n=613) from international travellers suspected of malaria were used, with microscopy corrected by polymerase chain reaction (PCR) as the reference method. Samples infected by P. falciparum (n=323), P. vivax (n=97), P. ovale (n=73) and P. malariae (n=25) were selected, as well as 95 malaria-negative samples. The overall sensitivities of the Immunoquick+4 for the diagnosis of P. falciparum, P. vivax, P. malariae and P. ovale were 88.9, 75.3, 56.0 and 19.2%, respectively. Sensitivity was significantly related to parasite density for P. falciparum (93.6% versus 71.4% at parasite densities >100/µl and ≤100/µl, respectively) and P. vivax (86.8% versus 48.3% at parasite densities >500/µl and ≤500/µl, respectively). The Immunoquick+4 showed good reproducibility and reliability for both test results and line intensities. The Immunoquick+4 performed well for the detection of P. falciparum and P. vivax. Background

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Immunochromatography-based rapid diagnostic tests for diagnosing uncomplicated malaria in endemic countries

Naing

Abba

Garner

et al. 2009

Cochrane Database of Systematic Reviews

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Meta-Analysis: Accuracy of Rapid Tests for Malaria in Travelers Returning from Endemic Areas

Cited by 152 publications

References 32 publications

Evaluation of a rapid diagnostic test (CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test) for the diagnosis of malaria in a reference setting

Evaluation of a rapid diagnostic test (CareStart™ Malaria HRP-2/pLDH (Pf/pan) Combo Test) for the diagnosis of malaria in a reference setting

Evaluation of the Immunoquick+4 malaria rapid diagnostic test in a non-endemic setting

Immunochromatography-based rapid diagnostic tests for diagnosing uncomplicated malaria in endemic countries

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