title: Evaluation of three rapid tests for diagnosis of P. falciparum and P. vivax malaria in Colombia.
abstract: The diagnostic capacity of three malaria rapid diagnostic tests (RDTs), NOW-Malaria-ICT, OptiMAL-IT, and Paracheck-Pf, was evaluated against expert microscopy in Colombia. We tested 896 patients, of whom microscopy confirmed 139 P. falciparum, 279 P. vivax, and 13 mixed P.f/P.v infections and 465 negatives. Paracheck-Pf and NOW-malaria-ICT were more accurate in detecting P. falciparum (sensitivities 90.8% and 90.1%, respectively) in comparison with Optimal-IT (83.6%). NOW showed an acceptable Pf detection rate at low densities (< 500/microL), but resulted in a higher proportion of false positives. For P. vivax diagnosis, Optimal-IT had a higher sensitivity than NOW (91.0% and 81.4%, respectively). The choice between the two Pf/Pv detecting RDTs balances P. falciparum and P. vivax detection rates. Considering some degree of P. falciparum overtreatment and failure to detect all P. vivax cases as more acceptable than missing some cases of P. falciparum, we recommend careful implementation of NOW-malaria-ICT in areas where microscopy is lacking. The price is however still a constraint.
authors.affiliation: Médecins sans Frontières (MSF), London, UK. ingrid_vandenbroek@yahoo.com
authors.forename: Ingrid
authors.initials: I
authors.lastname: van den Broek
authors.forename: Olivia
authors.initials: O
authors.lastname: Hill
authors.forename: Fabiola
authors.initials: F
authors.lastname: Gordillo
authors.forename: Bibiana
authors.initials: B
authors.lastname: Angarita
authors.forename: Prudence
authors.initials: P
authors.lastname: Hamade
authors.forename: Helen
authors.initials: H
authors.lastname: Counihan
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Guthmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003105:Colombia; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000175:diagnosis*; D016780:Malaria, Vivax / Q000175:diagnosis*; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000166:cytology / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000166:cytology / Q000302:isolation & purification; D011786:Quality Control