title: Evaluation of antigen detection tests, microscopy, and polymerase chain reaction for diagnosis of malaria in peripheral blood in asymptomatic pregnant women in Nanoro, Burkina Faso.
abstract: Rapid diagnostics tests (RDTs) detect malaria specific antigen(s) in the circulation, even when parasites are sequestered in the placenta and not visible by microscopy. However, research on their diagnostic accuracy during pregnancy is limited. Pregnant women (n = 418) were screened for malaria during routine antenatal care by using two RDTs that detect histidine-rich protein 2 (HRP2) or Plasmodium lactate dehydrogenase, and enzyme-linked immunosorbent assays with antibodies that detect dihydrofolate reductase-thymidylate synthase or heme-detoxification protein, and compared with real-time polymerase chain reaction (RT-PCR) and microscopy for evaluation of their diagnostic accuracy. Prevalence of malaria infection was high (53% by PCR). The RT-PCR and the HRP2 RDT detected most cases of malaria during pregnancy, whereas microscopy, the Plasmodium lactate dehydrogenase RDT, and enzyme-linked immunosorbent assays for dihydrofolate reductase-thymidylate synthase and heme-detoxification protein antibodies did not detect several low-density infections. Therefore, the HRP2 RDT could be a useful tool in high-transmission areas for diagnosis of malaria in asymptomatic pregnant women.
authors.affiliation: Koninklijk Instituut voor de Tropen Biomedical Research, Amsterdam, The Netherlands. e.kattenberg@kit.nl
authors.forename: Johanna H
authors.initials: JH
authors.lastname: Kattenberg
authors.forename: Christian M
authors.initials: CM
authors.lastname: Tahita
authors.forename: Inge A J
authors.initials: IA
authors.lastname: Versteeg
authors.forename: Halidou
authors.initials: H
authors.lastname: Tinto
authors.forename: Maminata
authors.initials: M
authors.lastname: Traoré Coulibaly
authors.forename: Umberto
authors.initials: U
authors.lastname: D'Alessandro
authors.forename: Henk D F H
authors.initials: HD
authors.lastname: Schallig
authors.forename: Petra F
authors.initials: PF
authors.lastname: Mens
mesh_terms: D000293:Adolescent; D000818:Animals; D000953:Antigens, Protozoan / Q000097:blood*; D002050:Burkina Faso / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016778:Malaria, Falciparum / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D009097:Multienzyme Complexes / Q000097:blood*; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D015995:Prevalence; D015800:Protozoan Proteins / Q000097:blood*; D016053:RNA, Protozoan / Q000737:chemistry / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013762:Tetrahydrofolate Dehydrogenase / Q000097:blood*; D013940:Thymidylate Synthase / Q000097:blood*; D055815:Young Adult
chemical_list: D000953:Antigens, Protozoan; C514457:HRP-2 antigen, Plasmodium falciparum; D009097:Multienzyme Complexes; D015800:Protozoan Proteins; D016053:RNA, Protozoan; C056930:thymidylate synthase-dihydrofolate reductase; D007770:L-Lactate Dehydrogenase; D013762:Tetrahydrofolate Dehydrogenase; D013940:Thymidylate Synthase