Performance of a histidine-rich protein 2 rapid diagnostic test, Paracheck Pf®, for detection of malaria infections in Ugandan pregnant women.
Improved laboratory diagnosis is critical to reduce the burden of malaria in pregnancy. Peripheral blood smears appear less sensitive than Plasmodium falciparum histidine-rich protein 2-based rapid diagnostic tests (RDTs) for placental malaria infections in studies conducted at delivery. In this study, 81 women in Uganda in the second or third trimester of pregnancy were followed-up until delivery. At each visit, peripheral blood was tested by blood smear, RDT, and nested species-specific polymerase chain reaction (PCR). Sensitivity and specificity of the tests was calculated with PCR, which detected 22 infections of P. falciparum, as the gold standard. The sensitivity and specificity of blood smears were 36.4% (95% confidence interval [CI] = 18.0-59.2%) and 99.6% (95% CI = 97.7-100%), respectively. The corresponding values for RDT were 31.8% (95% CI = 14.7-54.9%) and 100% (95% CI = 98.3-100%). The RDTs could replace blood smears for diagnosis of malaria in pregnancy by virtue of their relative ease of use. Field-based sensitive tests for malaria in pregnancy are urgently needed.
Epicentre, Mbarara, Uganda. mehul.dhorda@gmail.com
Mehul
M
Dhorda
Patrice
P
Piola
Dan
D
Nyehangane
Benon
B
Tumwebaze
Aisha
A
Nalusaji
Carolyn
C
Nabasumba
Eleanor
E
Turyakira
Rose
R
McGready
Elizabeth
E
Ashley
Philippe J
PJ
Guerin
Georges
G
Snounou
D000953:Antigens, Protozoan / Q000097:blood*; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005449:Fluorenes / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D015800:Protozoan Proteins / Q000097:blood*; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D013045:Species Specificity; D016896:Treatment Outcome; D014454:Uganda
D000953:Antigens, Protozoan; D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; C514457:HRP-2 antigen, Plasmodium falciparum; D015800:Protozoan Proteins; D011803:Quinine