Performance of Antigen Concentration Thresholds for Attributing Fever to Malaria among Outpatients in Angola.
Plasmodium falciparum
pyrogenic threshold
Journal
Journal of clinical microbiology
ISSN: 1098-660X
Titre abrégé: J Clin Microbiol
Pays: United States
ID NLM: 7505564
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
30
11
2018
accepted:
02
01
2019
pubmed:
11
1
2019
medline:
26
3
2020
entrez:
11
1
2019
Statut:
epublish
Résumé
The density of malaria parasites is a key determinant of whether an infected individual develops fever. While the pyrogenic threshold for malaria parasite density has been well studied, there are no analogous data on the antigen levels associated with fever during infection. Samples from 797 afebrile and 457 febrile outpatients from two provinces in Angola with known concentrations of histidine-rich protein 2 (HRP2), aldolase, and lactate dehydrogenase (LDH) antigens were analyzed by Bayesian latent class modeling to attribute malarial etiology to the fevers and to estimate the sensitivity and specificity of different antigen thresholds for detection of malaria fevers. Among patients with aldolase or LDH levels detectable with a bead-based assay, the concentrations of these two antigens did not differ between afebrile and febrile patients. In contrast, the concentrations of HRP2 were substantially higher in febrile HRP2-positive patients than in afebrile HRP2-positive patients. When HRP2 concentrations were considered, the malaria-attributable fractions of fever cases were 0.092 in Huambo Province and 0.39 in Uíge Province. Diagnostic tests detecting HRP2 with limits of detection (LODs) in the range of 3,000 to 10,000 pg/µl would provide ideal sensitivity and specificity for determination of malarial etiology among febrile persons.
Identifiants
pubmed: 30626660
pii: JCM.01901-18
doi: 10.1128/JCM.01901-18
pmc: PMC6425161
pii:
doi:
Substances chimiques
Antigens, Protozoan
0
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2019 American Society for Microbiology.
Références
Malar J. 2012 Jan 31;11:29
pubmed: 22289302
Malar J. 2014 Apr 30;13:163
pubmed: 24885660
Expert Rev Anti Infect Ther. 2013 Jun;11(6):623-39
pubmed: 23750733
Parasitology. 2005 Oct;131(Pt 4):449-58
pubmed: 16174409
PLoS One. 2017 Feb 13;12(2):e0172139
pubmed: 28192523
Stat Med. 1994 Nov 30;13(22):2345-58
pubmed: 7855468
Malar J. 2017 May 3;16(1):186
pubmed: 28468663
J Infect Dis. 2019 Jan 9;219(3):437-447
pubmed: 30202972
Am J Trop Med Hyg. 1996 Jun;54(6):613-9
pubmed: 8686780
Malar J. 2017 Nov 7;16(1):451
pubmed: 29115966
Malar J. 2009 Jul 14;8:158
pubmed: 19602275
Stat Methods Med Res. 1999 Jun;8(2):135-60
pubmed: 10501650
J Infect Dis. 2005 Jun 1;191(11):1932-9
pubmed: 15871128
J Infect Dis. 2018 Feb 14;217(5):685-692
pubmed: 29220497
Malar J. 2010 Jul 07;9:192
pubmed: 20609211
PLoS Med. 2005 Aug;2(8):e204
pubmed: 16104831
J Cell Biol. 1986 Oct;103(4):1269-77
pubmed: 3533951
Biometrics. 1989 Mar;45(1):255-68
pubmed: 2720055
Trop Med Int Health. 2005 Jun;10(6):550-6
pubmed: 15941418