Comparison of HRP2- and pLDH-based rapid diagnostic tests for malaria with longitudinal follow-up in Kampala, Uganda.

Abstract	Presumptive treatment of malaria results in significant overuse of antimalarials. Malaria rapid diagnostic tests (RDTs) may offer a reliable alternative for case management, but the optimal RDT strategy is uncertain. We compared the diagnostic accuracy of histidine-rich protein 2 (HRP2)- and plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as the gold standard, in a longitudinal study of 918 fever episodes over an 8-month period in a cohort of children in Kampala, Uganda. Sensitivity was 92% for HRP2 and 85% for pLDH, with differences primarily due to better detection with HRP2 at low parasite densities. Specificity was 93% for HRP2 and 100% for pLDH, with differences primarily due to rapid clearance of pLDH antigenemia after treatment of a previous malaria episode. RDTs may provide an effective strategy for improving rational delivery of antimalarial therapy; in Kampala, either test could dramatically decrease inappropriate presumptive treatments.
Authors	Heidi Hopkins, Wilson Kambale, Moses R Kamya, Sarah G Staedke, Grant Dorsey, Philip J Rosenthal
Journal	The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 76 Issue 6 Pg. 1092-7 (Jun 2007) ISSN: 0002-9637 [Print] United States
PMID	17556616 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References	Antigens, Protozoan DNA, Protozoan HRP-2 antigen, Plasmodium falciparum Protozoan Proteins Reagent Kits, Diagnostic L-Lactate Dehydrogenase
Topics	Animals Antigens, Protozoan (blood) Child Child, Preschool Cohort Studies DNA, Protozoan (chemistry, genetics) Humans Infant L-Lactate Dehydrogenase (blood) Longitudinal Studies Malaria, Falciparum (blood, diagnosis, enzymology, parasitology) Plasmodium falciparum (genetics, isolation & purification) Polymerase Chain Reaction Protozoan Proteins (blood) Reagent Kits, Diagnostic (parasitology) Sensitivity and Specificity Uganda

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