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. 2023 Jul 10;3(7):e0001879.
doi: 10.1371/journal.pgph.0001879. eCollection 2023.

Diagnostic performance of PfHRP2/pLDH malaria rapid diagnostic tests in elimination setting, northwest Ethiopia

Melkamu Tiruneh Zeleke  1 , Kassahun Alemu Gelaye  2 , Adugna Abera Hirpa  3 , Mahlet Belachew Teshome  3 , Geremew Tasew Guma  3 , Banchamlak Tegegne Abate  4 , Muluken Azage Yenesew  1
Affiliations

Diagnostic performance of PfHRP2/pLDH malaria rapid diagnostic tests in elimination setting, northwest Ethiopia

Melkamu Tiruneh Zeleke et al. PLOS Glob Public Health. .

Abstract

Accurate diagnosis of malaria is vital for the effectiveness of parasite clearance interventions in elimination settings. Thus, evaluating the diagnostic performance of rapid diagnostic tests (RDTs) used in malaria parasite clearance interventions in elimination settings is essential. Therefore, this study aimed to evaluate the diagnostic performance of rapid diagnostic tests recently used in detecting malaria parasites in northwest Ethiopia. A facility-based cross-sectional study was conducted from November 2020 to February 2021 comparing PfHRP2/pLDH CareStart malaria RDTs with light microscopy and polymerase chain reaction (PCR). Blood samples were collected from 310 febrile patients who attended the outpatient department and examined using CareStart RDTs, light microscopy, and PCR. Statistical analyses were performed using STATA/SE version 17.0. The sensitivity of PfHRP2/pLDH CareStart malaria RDTs, regardless of species, was 81.0% [95% CI, 75.3, 86.7] and 75.8% [95% CI, 69.6, 82.0] compared to light microscopy and PCR, while the specificity was 96.8% [95% CI, 93.7, 99.9] and 93.2% [95% CI, 88.6, 97.8], respectively. The false-negative rate of CareStart malaria RDTs in comparison with light microscopy and PCR was 19.0% and 24.2%, respectively. The level of agreement beyond chance between tests was substantial, RDT versus microscopy was 75.0% and RDT versus PCR was 65.1%. The diagnostic performance of PfHRP2/pLDH CareStart RDTs in detecting malaria parasites among febrile patients in the study area was below the recommended WHO standard. The limited diagnostic performance of RDTs in the malaria elimination area undoubtedly affects the impact of malaria parasite clearance interventions. Therefore, parasite clearance intervention like targeted mass drug administration with antimalarial drugs is recommended to back up the limited diagnostic performance of the RDT or replace the existing malaria RDTs with more sensitive, field-deployable, and affordable diagnostic tests.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. A study flowchart that showed patients’ enrollment, CareStart RDTs, Microscopy, and PCR test results.
See this image and copyright information in PMC

References

    1. WHO. World Malaria Report. Geneva: World Health Organization; 2021.
    1. Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al.. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526(7572):207–11. doi: 10.1038/nature15535 - DOI - PMC - PubMed
    1. Cibulskis RE, Alonso P, Aponte J, Aregawi M, Barrette A, Bergeron L, et al.. Malaria: global progress 2000–2015 and future challenges. Infectious diseases of poverty. 2016;5(1):61. doi: 10.1186/s40249-016-0151-8 - DOI - PMC - PubMed
    1. WHO. Global technical strategy for malaria 2016–2030. Geneva World Health Organization; 2015. Report No.: 9241564997.
    1. MOH. Ministry of Health, National Malaria Elimination Roadmap Addis Ababa, Ethiopia; The Federal Democratic Republic of Ethiopia, Ministry of Health; 2017.

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