title: Performance of HRP2-based rapid test in children attending the health centre compared to asymptomatic children in the community.
abstract: BACKGROUND
  The Democratic Republic of the Congo (DRC) is one of the five countries carrying half of global malaria burden with children 0-5 years old being most at risk. Rapid diagnostic tests (RDTs) are currently routinely used for the detection of Plasmodium infection in health centres and may be a useful tool for population-based survey.
  
  
  METHODS
  This study assessed, in a stable transmission zone of Kinshasa, whether a HRP2-based RDT matches the selection criteria of the National Malaria Control Programme (NMCP), DRC and assessed the most relevant fever threshold in this context.
  
  
  RESULTS
  RDTs and microscopy were concordant in 84.3% and 83.4% children in the health centre and at the community level, respectively. The sensitivity was high (>95%), but the specificity was too low and lower in the community (66.9%; 95%CI: 58.5-75.2) compared to the HC (79.4%; 95%CI: 75.7-83.2). The estimated parasitic threshold of 5,414 parasites/μl was with a sensitivity of 63.3% and a specificity of 71.8% not very discriminative, and thus not a threshold.
  
  
  CONCLUSIONS
  HRP-based RDT gives a satisfactory proxy to estimate and monitor malaria endemicity, but the low specificity, far below the selection criteria of the NMCP, DRC is problematic for use in a clinical setting.
authors.affiliation: Clinical Pharmacology Unit, University of Kinshasa, Kinshasa, Democratic Republic of Congo. gillonilombe@yahoo.fr.
authors.forename: Gillon
authors.initials: G
authors.lastname: Ilombe
authors.forename: Vivi
authors.initials: V
authors.lastname: Maketa
authors.forename: Hypolite Muhindo
authors.initials: HM
authors.lastname: Mavoko
authors.forename: Raquel Inocêncio
authors.initials: RI
authors.lastname: da Luz
authors.forename: Pascal
authors.initials: P
authors.lastname: Lutumba
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Van geertruyden
mesh_terms: D000953:Antigens, Protozoan / Q000032:analysis*; D058070:Asymptomatic Diseases; D002675:Child, Preschool; D060085:Coinfection / Q000175:diagnosis; D015023:Democratic Republic of the Congo; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008297:Male; D015800:Protozoan Proteins / Q000032:analysis*; D012680:Sensitivity and Specificity
chemical_list: D000953:Antigens, Protozoan; C514457:HRP-2 antigen, Plasmodium falciparum; D015800:Protozoan Proteins
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