Analysis of nucleic acids extracted from rapid diagnostic tests reveals a significant proportion of false positive test results associated with recent malaria treatment.
Antigens, Protozoan
/ analysis
Coinfection
/ diagnosis
Diagnostic Tests, Routine
/ statistics & numerical data
Equatorial Guinea
/ epidemiology
False Positive Reactions
Incidence
Malaria
/ diagnosis
Malaria, Falciparum
/ diagnosis
Nucleic Acids
/ analysis
Plasmodium falciparum
/ isolation & purification
Plasmodium malariae
/ isolation & purification
Plasmodium ovale
/ isolation & purification
Population Surveillance
Protozoan Proteins
/ analysis
Retrospective Studies
False-positive malaria rapid diagnostic test
Molecular malaria surveillance
PfHRP2 persistence
pfhrp2 gene deletion
Journal
Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802
Informations de publication
Date de publication:
24 Jan 2022
24 Jan 2022
Historique:
received:
21
06
2021
accepted:
07
01
2022
entrez:
25
1
2022
pubmed:
26
1
2022
medline:
3
2
2022
Statut:
epublish
Résumé
Surveillance programmes often use malaria rapid diagnostic tests (RDTs) to determine the proportion of the population carrying parasites in their peripheral blood to assess the malaria transmission intensity. Despite an increasing number of reports on false-negative and false-positive RDT results, there is a lack of systematic quality control activities for RDTs deployed in malaria surveillance programmes. The diagnostic performance of field-deployed RDTs used for malaria surveys was assessed by retrospective molecular analysis of the blood retained on the tests. Of the 2865 RDTs that were collected in 2018 on Bioko Island and analysed in this study, 4.7% had a false-negative result. These false-negative RDTs were associated with low parasite density infections. In 16.6% of analysed samples, masked pfhrp2 and pfhrp3 gene deletions were identified, in which at least one Plasmodium falciparum strain carried a gene deletion. Among all positive RDTs analysed, 28.4% were tested negative by qPCR and therefore considered to be false-positive. Analysing the questionnaire data collected from the participants, this high proportion of false-positive RDTs could be explained by P. falciparum histidine rich protein 2 (PfHRP2) antigen persistence after recent malaria treatment. Malaria surveillance depending solely on RDTs needs well-integrated quality control procedures to assess the extent and impact of reduced sensitivity and specificity of RDTs on malaria control programmes.
Sections du résumé
BACKGROUND
BACKGROUND
Surveillance programmes often use malaria rapid diagnostic tests (RDTs) to determine the proportion of the population carrying parasites in their peripheral blood to assess the malaria transmission intensity. Despite an increasing number of reports on false-negative and false-positive RDT results, there is a lack of systematic quality control activities for RDTs deployed in malaria surveillance programmes.
METHODS
METHODS
The diagnostic performance of field-deployed RDTs used for malaria surveys was assessed by retrospective molecular analysis of the blood retained on the tests.
RESULTS
RESULTS
Of the 2865 RDTs that were collected in 2018 on Bioko Island and analysed in this study, 4.7% had a false-negative result. These false-negative RDTs were associated with low parasite density infections. In 16.6% of analysed samples, masked pfhrp2 and pfhrp3 gene deletions were identified, in which at least one Plasmodium falciparum strain carried a gene deletion. Among all positive RDTs analysed, 28.4% were tested negative by qPCR and therefore considered to be false-positive. Analysing the questionnaire data collected from the participants, this high proportion of false-positive RDTs could be explained by P. falciparum histidine rich protein 2 (PfHRP2) antigen persistence after recent malaria treatment.
CONCLUSION
CONCLUSIONS
Malaria surveillance depending solely on RDTs needs well-integrated quality control procedures to assess the extent and impact of reduced sensitivity and specificity of RDTs on malaria control programmes.
Identifiants
pubmed: 35073934
doi: 10.1186/s12936-022-04043-7
pii: 10.1186/s12936-022-04043-7
pmc: PMC8785039
doi:
Substances chimiques
Antigens, Protozoan
0
HRP-2 antigen, Plasmodium falciparum
0
Nucleic Acids
0
Protozoan Proteins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
23Subventions
Organisme : staatssekretariat für bildung, forschung und innovation
ID : 2016.1250
Organisme : staatssekretariat für bildung, forschung und innovation
ID : 2017.0748
Informations de copyright
© 2022. The Author(s).
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