Poor performance of malaria rapid diagnostic tests for the detection of Plasmodium malariae among returned international travellers in China

Wu, J; Tang, Jianxia; Wang, Weiming; Chen, Gangcheng; He, Xiaoqin; Xu, Shutu; Cao, Yuanyuan; Gu, Yixuan; Zhu, Guoding; Cao, Jun

doi:10.1186/s12936-023-04596-1

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…[14]. Notably, RDTs have lower sensitivity for P. vivax compared with Plasmodium falciparum (P. falciparum) [15]. In the midst of these challenges, we observed that the iRBC flags in the hematology results were not affected, mainly due to significant changes in erythrocytes during parasitic infections.…”

Section: Discussionmentioning

confidence: 81%

Rapid Detection of Plasmodium vivax by the Hematology Analyzer for Population Screening

Khodaiji,

Sehgal,

Sethi

et al. 2023

Diagnostics

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In India, where malaria is endemic, the prompt and accurate detection of infections is crucial for disease management and vector control. Our study aimed to evaluate the “iRBC” flag, a novel parameter developed for routine hematology analyzers, for its sensitivity and specificity in detecting Plasmodium vivax (P. vivax) infections. We used residual blood samples from patients with suspected malaria and compared the iRBC flag results with microscopy, which serves as the gold standard. Additionally, we compared the results with rapid immuno-chromatographic tests (RDTs) commonly used in the field. Our study included 575 samples, of which 187 were positive for P. vivax. The iRBC flag demonstrated a high sensitivity of 88.7% and 86.1% on the XN and XN-L hematology analyzers, respectively, and a clinical specificity of 100% on both analyzers. Furthermore, the scattergram derived from each positive dataset exhibited distinct patterns, which facilitated rapid confirmation by laboratory specialists. Notably, the iRBC flag remained effective even in the presence of interfering conditions. Overall, our results indicate that the iRBC flag is a reliable and rapid screening tool for identifying P. vivax in routine blood testing. Our findings have significant implications for malaria detection and control in endemic regions like India.

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Section: Discussionmentioning

confidence: 81%

Rapid Detection of Plasmodium vivax by the Hematology Analyzer for Population Screening

Khodaiji,

Sehgal,

Sethi

et al. 2023

Diagnostics

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“…In cases of P. malariae malaria, misdiagnosis is linked to the poor performance of RDTs, underlined in the majority of manufactured RDT [15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of SD Bioline Malaria Ag Pf/Pan and Acro Malaria P.f./P.v./Pan with Microscopy and Real Time PCR for the Diagnosis of Human Plasmodium Species

Madamet,

Fonta,

Mosnier

et al. 2024

Diagnostics

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The early diagnosis of malaria is crucial to controlling morbidity and mortality. The World Health Organization (WHO) recommends diagnosing malaria either using light microscopy or a malaria rapid diagnostic test (RDT). Most RDTs use antibodies to detect two P. falciparum histidine-rich proteins named PfHRP2 and PfHRP3. However, false-negative results are known to occur due to the poor performance of RDTs depending on the species and the deletion of the Pfhrp2 and Pfhrp3 genes. This study evaluated new malaria RDTs for the detection of the human Plasmodium species. The Acro Malaria P.f./P.v./Pan Rapid Test Cassette allows the qualitative detection of parasite antigens, such as PfHRP2 specific to Plasmodium falciparum, PvLDH specific to Plasmodium vivax, and/or panLDH Plasmodium genus lactate dehydrogenase, in the blood of infected individuals. This RDT was assessed against 229 samples collected from imported malaria cases, mainly from Africa. The samples were previously diagnosed using light microscopy and RDT (SD Malaria Ag P.f./Pan, SD Bioline Alere Abbott), then confirmed using real time PCR. The two RDTs were evaluated using a comparison with real time PCR as the reference method, and their performances were compared with each other. Compared to SD RDT, the Acro RDT showed a better sensitivity to P. falciparum (96.8% vs. 89.8%), P. vivax (78.6% vs. 64.3%), P. ovale (73.7% vs. 5.3%), and P. malariae (20.0% vs. 0%). The respective specificities of the Acro RDT and SD RDT are 90.7% vs. 95.3% to P. falciparum, 100% to P. vivax, and 100% vs. 100% to Plasmodium genus. Therefore, Acro RDT showed better performance in the identification of P. ovale and low parasitaemia of P. falciparum. In addition, Acro RDT has the advantage of detecting PvLDH-specific antigens. The Acro Malaria RDT presents the benefits of detecting a P. falciparum antigen (PfHRP2) and a P. vivax antigen (PvLDH) with high sensitivity (96.8% and 73.7%, respectively) and specificity (90.7% and 100%, respectively). Acro Malaria P.f./P.v./Pan rapid diagnostic tests could be effectively used in endemic areas, especially when microscopic examination cannot be performed.

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“…Recently, Wu et al reported that RDT had a low detection rate (56.5%) among P. malariae cases from returned international travelers in China [ 5 ]. Overall, the sensitivity of RDTs greatly depends on the parasitemia of the samples [ 5 , 6 , 7 ]. To date, there is no RDT for the specific detection of P. knowlesi samples available on the market.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of A Simple DNA Extraction Method and Its Combination with Loop-Mediated Isothermal Amplification Assays for Rapid Plasmodium knowlesi Diagnosis

Lai,

Abdul Hamid,

Jelip

et al. 2023

TropicalMed

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The initial and vital stage in the diagnosis of malaria involves extracting DNA. The efficiency of malaria testing is restricted by the multiple steps involved in commercial DNA extraction kits. We attempted to improve an existing loop-mediated isothermal amplification (LAMP) for the detection of Plasmodium knowlesi by using a simple DNA extraction approach, making it a feasible option for mass screening. We utilized a simple nucleic acid extraction method directly from whole blood for the detection of P. knowlesi, taking only 5 min to complete. The extracted DNA was evaluated by two fluorescent-based LAMP and one colorimetric-based LAMP assay. The detection limit for both SYTO-LAMP and SYBR green-LAMP was 0.00001% and 0.0001% parasitemia, respectively. Meanwhile, neutral red-LAMP had a detection limit of 0.01% parasitemia. Combining this simple and inexpensive DNA extraction method, SYTO-LAMP could serve as an alternative molecular diagnosis for the detection of P. knowlesi and other human Plasmodium spp.

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Poor performance of malaria rapid diagnostic tests for the detection of Plasmodium malariae among returned international travellers in China

Cited by 5 publications

References 21 publications

Rapid Detection of Plasmodium vivax by the Hematology Analyzer for Population Screening

Rapid Detection of Plasmodium vivax by the Hematology Analyzer for Population Screening

Comparison of SD Bioline Malaria Ag Pf/Pan and Acro Malaria P.f./P.v./Pan with Microscopy and Real Time PCR for the Diagnosis of Human Plasmodium Species

Evaluation of A Simple DNA Extraction Method and Its Combination with Loop-Mediated Isothermal Amplification Assays for Rapid Plasmodium knowlesi Diagnosis

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