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. 2012 Jan;2(1):35-7.
doi: 10.4103/2229-5070.97237.

The accuracy of the first response histidine-rich protein2 rapid diagnostic test compared with malaria microscopy for guiding field treatment in an outbreak of falciparum malaria

Abdulla Salim Bin Ghouth  1 , Faraj Mubarak Nasseb, Khaled Hussin Al-Kaldy
Affiliations

The accuracy of the first response histidine-rich protein2 rapid diagnostic test compared with malaria microscopy for guiding field treatment in an outbreak of falciparum malaria

Abdulla Salim Bin Ghouth et al. Trop Parasitol. 2012 Jan.

Abstract

Background: Recent WHO guidelines recommended a universal "test and treat" strategy for malaria mainly by use of the rapid diagnostic test (RDT) in all areas. There are concerns about RDT that use the antigen histidine-rich protein2 (HRP2) to detect Plasmodium falciparum, because infection can persist after effective treatment.

Aim: The aim of this paper is to describe the accuracy of the first response (HRP2)-RDT compared with malaria microscopy used for guiding the field treatment of patients in an outbreak situation in the Al-Rahabah area in Al-Rydah district in Hadramout/Yemen.

Materials and methods: An ad hoc cross sectional survey of all febrile patients in the affected area was conducted in May 2011. The field team was developed including the case management group and the entomology group. The group of case management prepared their plan based on "test and treat" strategy by using First Response Malaria Antigen HRP2 rapid diagnostic test for falciparum malaria, artemsinin-based combination therapy (ACT) according to the national policy of anti-malaria drugs in Yemen were supplied to treat those who were found to be RDT positive in the field; also blood smear films were taken from every patient with fever in order to validate the use of the RDT in the field. Blood film slides prepared and read by skilled lab technicians, the fourth reading was done by one lab expert in the malaria referral lab.

Results: The accuracy parameters of HRP2 compared with microscopy are: Sensitivity (74%), specificity (94%). The positive predictive value is 68% and the negative predictive value is 96%. Total agreement is 148/162 (93%) and the overall prevalence is 14%. All the positive malaria cases were of P. falciparum either coming from RDT or microscopy.

Conclusions: HRP2-rapid test is an acceptable test as a guide for field treatment in an outbreak situation where prompt response is indicated. Good prepared blood film slides should be used as it is feasible to evaluate the accuracy of RDTs as a quality control tool.

Keywords: Malaria; Yemen; rapid diagnostic test.

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Conflict of interest statement

Conflict of Interest: There is no conflict of interest

References

    1. Bisoffi Z, Sirima SB, Menten J, Pattaro C, Angheben A, Gobbi F, et al. Accuracy of a rapid diagnostic test on the diagnosis of malaria infection and of malaria-attributable fever during low and high transmission season in Burkina Faso. Malar J. 2010;9:192. - PMC - PubMed
    1. Graz B, Willcox M, Szeless T, Rougemont A. “Test and Treat” or presumptive treatment for malaria in high transmission situations? A reflection on the latest WHO guidelines. Malar J. 2011;10:136. - PMC - PubMed
    1. Kyabayinze DJ, Tibenderana JK, Odong GW, Rwakimari JB, Counihan H. Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J. 2008;7:221. - PMC - PubMed
    1. Premier Medical Corporation Ltd. First Response Malaria Antigen, P. falciparum (HRP2) card test: Instruction for use. India. [Last accessed on 2011 Jul 10]. Available from: http://www.premiermedcorp.com/rapidtests.html .
    1. Mtove G, Nadjm B, Amos B, Hendriksen IC, Muro F, Reyburn H. Use of an HRP2-based rapid diagnostic test to guide treatment of children admitted to hospital in a malaria-endemic area of north-east Tanzania. Trop Med Int Health. 2011;16:545–50. - PMC - PubMed