title: Comparison of three antigen detection tests for diagnosis and follow-up of falciparum malaria in travellers returning to Berlin, Germany.
abstract: We determined the sensitivity and specificity of three rapid immunochromatographic malarial antigen detection test systems (RDTs) for the detection of Plasmodium falciparumand assessed the quality of follow-up results. ParaSight-F and ICT Malaria detect histidine-rich protein-2 (HRP-2), whereas OptiMal detects plasmodial lactate dehydrogenase (pLDH). ParaSight-F performed with 95.1% sensitivity and 97.1% specificity (554 patients tested of whom 144 had falciparum malaria). ICT Malaria performed with 95.7% sensitivity and 99.2% specificity (718 patients tested of whom 184 had falciparum malaria). OptiMal performed with 76.2% sensitivity and 99.7% specificity (539 patients tested of whom 130 had falciparum malaria). In follow-up investigations, HRP-2 did not appear to be a useful antigen due to its long half-life, whereas pLDH offers a reasonable correlation with the presence of viable parasites in those cases initially detected. We therefore conclude that a combination of both antigens might be the best option for creating a reliable RDT for the diagnosis of falciparum malaria.
authors.affiliation: Department of Parasitology, Institute of Tropical Medicine, Eberhard Karls University, Wilhelmstrasse 27, 72074 Tuebingen, Germany. martin.grobusch@uni-tuebingen.de
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Thomas
authors.initials: T
authors.lastname: Hänscheid
authors.forename: Klaus
authors.initials: K
authors.lastname: Göbels
authors.forename: Hortense
authors.initials: H
authors.lastname: Slevogt
authors.forename: Thomas
authors.initials: T
authors.lastname: Zoller
authors.forename: Gertrud
authors.initials: G
authors.lastname: Rögler
authors.forename: Dieter
authors.initials: D
authors.lastname: Teichmann
mesh_terms: D000818:Animals; D000953:Antigens, Protozoan / Q000032:analysis*; D001604:Berlin; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008853:Microscopy / Q000379:methods; D010963:Plasmodium falciparum / Q000276:immunology / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity
chemical_list: D000953:Antigens, Protozoan; D011933:Reagent Kits, Diagnostic