Comparison of rapid diagnostic tests for the detection of Plasmodium vivax malaria in South Korea

Abstract

South Korea is one of many countries with endemic Plasmodium vivax malaria. Here we report the evaluation of four rapid diagnostic tests (RDTs) for diagnosis of this disease. A total of 253 subjects were enrolled in the study. The sensitivities, specificities and agreement frequencies were estimated by comparing the four RDTs against the standard of nested-PCR and microscopic examination. The CareStart(TM) and SD Bioline had higher test sensitivities (99.4 and 98.8%, respectively) compared with the NanoSign and Asan Easy tests (93.0 and 94.7%, respectively). The CareStart(TM) and SD Bioline tests could detect P. vivax in samples with parasite densities <150/μl, which was a slightly better performance than the other two RDTs. The quantitative accuracy of the four RDTs was also estimated by comparing results with P. vivax counts from blood samples. Lower test price would result in increased use of these RDTs in the field. The results of this study contribute valuable information that will aid in the selection of a diagnostic method for the detection of malaria.

Figure 1. Sample selection profile for the evaluation of four rapid diagnostic tests.

Microscopic examination, nested-PCR, and rapid diagnostic tests were performed.

Figure 2. Correlation between intensity of the positive band of four rapid diagnostic tests (CareStart^TM, SD Bioline, NanoSign, and Asan Easy) and parasitemia (determined by count of thick blood smears).

***; If the strength of positive line is greater than that of control line (Control line < Positive line), **; If the strength of the positive line is similar to the control line (Control line  =  Positive line), *; If the strength of the positive line is less than the control line (Control line > Positive line).