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. 2023 Jun;47(2):280-289.
doi: 10.1007/s12639-023-01566-x. Epub 2023 Jan 19.

Performance of Pf HRP2-RDT for malaria diagnosis during the first year of life in a high malaria transmission area in Burkina Faso

Hamtandi Magloire Natama  1 , Tiampan Edwig Traoré  1 , Toussaint Rouamba  1 , M Athanase Somé  1 , Serge Henri Zango  1 , Eduard Rovira-Vallbona  2 , Hermann Sorgho  1 , Pieter Guetens  3 , Maminata Coulibaly-Traoré  1 , Innocent Valéa  1 , Halidou Tinto  1 , Anna Rosanas-Urgell  3
Affiliations

Performance of Pf HRP2-RDT for malaria diagnosis during the first year of life in a high malaria transmission area in Burkina Faso

Hamtandi Magloire Natama et al. J Parasit Dis. 2023 Jun.

Abstract

In this study, we evaluated the performance of a P. falciparum Histidine Rich Protein 2 (PfHRP2)-based rapid diagnostic test (RDT) used for malaria case detection (SD-Bioline malaria RDT P.f®) along with light microscopy (LM) against qPCR among children during the first year of life in a high and seasonal malaria transmission area in Burkina Faso. A total of 723 suspected malaria cases (including multiple episodes) that occurred among 414 children participating in a birth-cohort study were included in the present analysis. Factors including age at the time of malaria screening, transmission season and parasite densities were investigated for their potential influence in the performance of the RDT. Clinical malaria cases as detected by RDT, LM and qPCR were 63.8%, 41.5% and 49.8%, respectively. Compared with qPCR, RDT had a false-positive results rate of 26.7%, resulting in an overall accuracy of 79.9% with a sensitivity of 93%, a specificity of 66.1%, a Positive Predictive Value of 73.3% and a Negative Predictive Value of 91.6%. Its specificity differed significantly between high and low transmission seasons (53.7% vs 79.8%; P < 0.001) and decreased with increasing age (80.6-62%; P for trend = 0.024). The overall accuracy of LM was 91.1% and its performance was not significantly influenced by transmission season or age. These findings highlight the need to adapt malaria diagnostic tools recommendations to face the challenge of adequate malaria detection in this population group living in high burden and seasonal malaria transmission settings.

Keywords: Infants; Malaria; Performance; PfHRP2; RDT.

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Conflict of interest statement

Conflict of interestThe authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow diagram of the selection of samples included in the analysis
Fig. 2
Fig. 2
Malaria diagnosis by RDT, LM and qPCR. (a) Stacked bar chart showing the relative proportion of positive samples per diagnostic tool; (b) Venn diagram showing matched and discrepancy positive results between SD-Bioline Malaria RDT P.f®, LM and qPCR
Fig. 3
Fig. 3
Forest plot showing significant variability of the specificity (but not the sensitivity) of SD-Bioline malaria RDT P.f® against qPCR by transmission season (TS) for each age group. Data are shown along with sensitivity and specificity for the total suspected malaria cases tested for each age group. For children screened for malaria during ]0–3] months of age, only data for the total suspected malaria cases tested are shown because of limited sample size for this age group
See this image and copyright information in PMC

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