Persistent ICT Malaria P.f/P.v Panmalarial and HRP2 Antigen Reactivity after Treatment of
            <i>Plasmodium falciparum</i>
            Malaria Is Associated with Gametocytemia and Results in False-Positive Diagnoses of
            <i>Plasmodium vivax</i>
            in Convalescence

Tjitra, Emiliana; Suprianto, Sri; McBroom, James; Currie, Bart J.; Anstey, Nicholas M.

doi:10.1128/jcm.39.3.1025-1031.2001

Cited by 100 publications

(97 citation statements)

References 18 publications

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“…This suggests that overall predictive accuracy may be improved by modifying current rapid diagnostic test formats to provide more quantitative data, particularly if these are used in conjunction with clinical assessment. 2 The results of this and a companion study 20 support the consensus that persistence of HRP2 antigenemia after clearance of asexual stages results in false-positive findings in convalescence and contributes to the suboptimal accuracy of HRP2 tests in predicting treatment outcome. 2 There are only limited data on posttreatment persistence of HRP2 antigenemia with the immunoglobulin (Ig) M monoclonal antibody to HRP2 used in the ICT Pf 6 and Pf/Pv tests, 16,18,20 but these suggest rates of persistence at least as high as those found with the IgG HRP2 monoclonal antibody used in the ParaSight-F test.…”

Section: Discussionmentioning

confidence: 55%

“…Sixty-six febrile Sumbanese with uncomplicated falciparum malaria were selected according to the 1997 WHO criteria for assessment of therapeutic efficacy of antimalarial drugs for uncomplicated falciparum malaria in areas with low or moderate transmission. 17,20 Parasite densities ranged from 1,160-32,400/L. 21 Patients were treated with a total of orally administered chloroquine 25 mg base per kilogram of body weight over 3 days.…”

Section: Methodsmentioning

confidence: 99%

“…17 The ICT Malaria Pf/Pv test is based on the immunochromatographic detection of the P. falciparum-specific HRP2 antigen and a panmalarial antigen found in asexual stages of P. falciparum and P. vivax and sexual stages of P. falciparum. [18][19][20] In our recent evaluation of this test in eastern Indonesia, we found the ICT Pf/Pv test to be very sensitive for the detection of P. falciparum but less so (75%) for detection of P. vivax. 18 In contrast to HRP2, there are few data on the persistence of the panmalarial antigen after clearance of parasitemia.…”

Section: Introductionmentioning

confidence: 99%

“…15 In endemic areas, however, we found the panmalarial antigen to persist despite clearance of asexual parasitemia with treatment, with clearance of this antigen paralleling clearance of sexual-stage parasites (gametocytes). 20 The purpose of this study, therefore, was to undertake serial ICT Pf/Pv testing in conjunction with the 1997 WHO protocol for assessment of efficacy of antimalarial drugs in order to evaluate longitudinally the utility of both HRP2 and panmalarial antigen detection in predicting treatment outcome after chloroquine therapy of uncomplicated falciparum malaria.…”

Section: Introductionmentioning

confidence: 99%

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Detection of histidine rich protein 2 and panmalarial ICT Malaria Pf/Pv test antigens after chloroquine treatment of uncomplicated falciparum malaria does not reliably predict treatment outcome in eastern Indonesia.

Tjitra

Suprianto

Dyer³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. In regions with drug-resistant malaria, the ability to rapidly detect or predict treatment failure (TF) soon after a course of standard therapy for Plasmodium falciparum malaria would facilitate the prompt institution of secondline therapy. We thus evaluated longitudinally the ability of the ICT Malaria Pf/Pv immunochromatographic test to predict treatment outcome. Sixty-six Sumbanese Indonesians with uncomplicated falciparum malaria were treated with chloroquine and followed for 28 days by use of 1997 World Health Organization criteria for assessment of therapeutic efficacy of antimalarial drugs. The ICT Pf/Pv testing could be compared with microscopy in approximately half of the patients on each day of follow-up. Although strongly positive histidine rich protein 2 (HRP2) line intensities (equal to or greater than the control band) in convalescence were highly predictive of TF, any degree of positivity for the HRP2 and panmalarial antigens in convalescence was only moderately predictive of TF. Positive predictive values of the HRP2 and panmalarial antigens for TF were 76.9% and 87.0%, respectively, on Day 3, 82.4% and 87.5% on Day 7, and 78.9% and 78.9% on Day 14. Negative HRP2 and panmalarial antigen results in convalescence were even less predictive of an adequate clinical response, and false-negative HRP2 and panmalarial antigen test results were found in one-sixth (6 of 37) of recrudescent infections diagnosed by microscopy among patients with late treatment failure. To reliably predict treatment outcome with rapid antigen tests, further development appears necessary to improve sensitivity for viable asexual parasites while avoiding detection of both gametocytes and persistent antigen in convalescence.

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Section: Discussionmentioning

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection of histidine rich protein 2 and panmalarial ICT Malaria Pf/Pv test antigens after chloroquine treatment of uncomplicated falciparum malaria does not reliably predict treatment outcome in eastern Indonesia.

Tjitra

Suprianto

Dyer³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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“…42,43 In addition, HRP2 antigen can persist in the blood for up to two weeks after resolution of blood-stage parasite infection, 44 partly because of carriage by gametocytes. 45 Thus, HRP2-based RDTs should not be used for patient follow-up for at least one month after treatment. 46 Lactate dehydrogenase is a less sensitive target, and LDH-specific assays can be designed to detect P. falciparum LDH or non-P. falciparum LDH.…”

Section: Rapid Diagnostic Testsmentioning

confidence: 99%

Malaria Diagnostics in Clinical Trials

Murphy¹,

Shott²,

Parikh³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Malaria diagnostics are widely used in epidemiologic studies to investigate natural history of disease and in drug and vaccine clinical trials to exclude participants or evaluate efficacy. The Malaria Laboratory Network (MLN), managed by the Office of HIV/AIDS Network Coordination, is an international working group with mutual interests in malaria disease and diagnosis and in human immunodeficiency virus/acquired immunodeficiency syndrome clinical trials. The MLN considered and studied the wide array of available malaria diagnostic tests for their suitability for screening trial participants and/or obtaining study endpoints for malaria clinical trials, including studies of HIV/ malaria co-infection and other malaria natural history studies. The MLN provides recommendations on microscopy, rapid diagnostic tests, serologic tests, and molecular assays to guide selection of the most appropriate test(s) for specific research objectives. In addition, this report provides recommendations regarding quality management to ensure reproducibility across sites in clinical trials. Performance evaluation, quality control, and external quality assessment are critical processes that must be implemented in all clinical trials using malaria tests.

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Rapid diagnostic tests for diagnosing uncomplicatedP. falciparummalaria in endemic countries

Abba

Deeks

Olliaro

et al. 2011

Cochrane Database of Systematic Reviews

189

180

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BackgroundRapid diagnostic tests (RDTs) for Plasmodium falciparum malaria use antibodies to detect either HRP-2 antigen or pLDH antigen, and can improve access to diagnostics in developing countries. ObjectivesTo assess the diagnostic accuracy of RDTs for detecting P. falciparum parasitaemia in persons living in endemic areas who present to ambulatory healthcare facilities with symptoms suggestive of malaria by type and brand.

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Persistent ICT Malaria P.f/P.v Panmalarial and HRP2 Antigen Reactivity after Treatment of Plasmodium falciparum Malaria Is Associated with Gametocytemia and Results in False-Positive Diagnoses of Plasmodium vivax in Convalescence

Cited by 100 publications

References 18 publications

Detection of histidine rich protein 2 and panmalarial ICT Malaria Pf/Pv test antigens after chloroquine treatment of uncomplicated falciparum malaria does not reliably predict treatment outcome in eastern Indonesia.

Detection of histidine rich protein 2 and panmalarial ICT Malaria Pf/Pv test antigens after chloroquine treatment of uncomplicated falciparum malaria does not reliably predict treatment outcome in eastern Indonesia.

Malaria Diagnostics in Clinical Trials

Rapid diagnostic tests for diagnosing uncomplicatedP. falciparummalaria in endemic countries

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