Diagnosis of malaria by detection of Plasmodium falciparum HRP-2 antigen with a rapid dipstick antigen-capture assay.

Abstract

Two field studies in Kenya and an experimental challenge study in the USA were done to assess the accuracy of a dipstick antigen-capture assay based on qualitative detection of Plasmodium falciparum histidine-rich protein 2 (PfHRP-2) in peripheral blood for diagnosis of P falciparum infection. In these studies, the assay was 96.5-100% sensitive for detection of greater than 60 P falciparum asexual parasites/microL blood, 70-81% sensitive for 11-60 parasites/microL blood, and 11-67% sensitive for 10 parasites or less/microL blood. Specificity was 95% (95% CI 85-105%; n = 20) among naive American volunteers, 98% (96-101%; n = 112) among volunteers exposed to the bite of P falciparum-infected mosquitoes, and 88% (84-92%; n = 285) among Kenyans living in an area with holoendemic malaria. Our results also indicated that PfHRP-2 antigen was not detectable in blood 6 days after initiation of curative chemotherapy, and suggest that such circulating antigens rarely lead to false-positive tests. The dipstick assay's sensitivity, specificity, simplicity, and speed may make it an important tool in the battle against malaria.

• Authors: C Beadle, G W Long, W R Weiss, P D McElroy, S M Maret, A J Oloo, S L Hoffman
• Journal: Lancet (London, England) (Lancet) Vol. 343 Issue 8897 Pg. 564-8 (Mar 05 1994) ISSN: 0140-6736 [Print] England
• PMID: 7906328 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Antigens, Protozoan
• Protozoan Proteins
• Reagent Strips

Topics

• Adolescent
• Adult
• Animals
• Antigens, Protozoan (blood)
• Child
• Female
• Humans
• Malaria, Falciparum (diagnosis, immunology)
• Male
• Plasmodium falciparum (immunology)
• Predictive Value of Tests
• Protozoan Proteins (blood)
• Reagent Strips
• Sensitivity and Specificity