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.

CONCLUSION:

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: Gillon Ilombe, Vivi Maketa, Hypolite Muhindo Mavoko, Raquel Inocêncio da Luz, Pascal Lutumba, Jean-Pierre Van geertruyden
• Journal: Malaria journal (Malar J) Vol. 13 Pg. 308 (Aug 09 2014) ISSN: 1475-2875 [Electronic] England
• PMID: 25108305 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, Protozoan
• HRP-2 antigen, Plasmodium falciparum
• Protozoan Proteins

Topics

• Antigens, Protozoan (analysis)
• Asymptomatic Diseases
• Child, Preschool
• Coinfection (diagnosis)
• Democratic Republic of the Congo
• Diagnostic Tests, Routine (methods)
• Female
• Humans
• Immunoassay (methods)
• Infant
• Infant, Newborn
• Malaria, Falciparum (diagnosis)
• Male
• Protozoan Proteins (analysis)
• Sensitivity and Specificity