Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 29:4:1598280.
doi: 10.3389/fpara.2025.1598280. eCollection 2025.

RDT performance through high-throughput bead-based antigen detection during malaria school survey in Senegal

Mamadou Alpha Diallo  1 , Ibrahima M Ndiaye  1 , Djiby Sow  1 , Mame Cheikh Seck  1 , Khadim Diongue  1 , Mariama Touré  1 , Katerine E Battle  2 , Bassirou Ngom  1 , Mouhamad Sy  1 , Amy Gaye  1 , Yaye Dié Ndiaye  1 , Mamane Nassirou Garba  1 , Aida Sadikh Badiane  1 , Aita Sene  1 , Medoune Ndiop  3 , Jules François Gomis  1 , Sarah K Volkman  4 , Doudou Sene  3 , Bronwyn L MacInnis  5 , Ibrahima Diallo  3 , Mouhamadou Ndiaye  1 , Dyann F Wirth  4 , Daouda Ndiaye  1
Affiliations

RDT performance through high-throughput bead-based antigen detection during malaria school survey in Senegal

Mamadou Alpha Diallo et al. Front Parasitol. .

Abstract

Background: Rapid Diagnostic Tests (RDTs) remain the frontline tool for malaria diagnosis, but their performance in detecting low-density infections is variable and poorly characterized at the population level.

Objective: This study aimed to evaluate the diagnostic performance of HRP2-based RDTs by integrating high-throughput bead-based HRP2 quantification into school-based malaria surveys.

Methods: A cross-sectional study was conducted in three Senegalese districts (Diourbel, Tambacounda, and Kédougou), enrolling 3,748 school-aged children. All participants were tested using RDTs, and dried blood spots were analyzed with a multiplex bead-based HRP2 assay. A Gaussian mixture model was used to classify HRP2 positivity, and logistic regression assessed the relationship between HRP2 concentration and RDT outcome.

Results: The overall RDT positivity rate was 7.2%, with marked heterogeneity across districts (Diourbel: 3.0%, Kédougou: 15.9%, Tambacounda: 7.6%). HRP2 concentration was the strongest predictor of RDT positivity (aOR: 14.55 per log10 increase, 95% CI: 11.14-19.00). RDT limits of detection (LOD95) varied significantly: 3.9 ng/mL in Tambacounda, 121.2 ng/mL in Kédougou, and 204.3 ng/mL in Diourbel.

Conclusion: RDTs remain a useful surveillance tool, particularly in moderate- to high-transmission settings. However, reduced sensitivity at lower antigen concentrations in hypo-endemic areas highlights the value of complementary high-sensitivity assays for elimination-focused strategies. Future research should explore the application of these integrated diagnostic approaches in regions without seasonal malaria chemoprophylaxis intervention.

Keywords: Senegal; high-throughput bead-based antigen detection; malaria surveillance; rapid diagnostic tests (RDTs); school-based surveys.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Map of Senegal highlighting the three study districts. Districts in red labeled Pecadom (prise en charge à domicile) have a community health worker program.
Figure 2
Figure 2
Probability of RDT positivity in relation to HRP2 concentration across districts. The LOESS curves (blue line) and logistic regression models (red line) show the probability of RDT positivity as a function of log10 HRP2 concentration. Shaded areas represent the 95% confidence intervals of the LOESS and logistic models.
See this image and copyright information in PMC

References

    1. Badiane A. S., Ndiaye T., Thiaw A. B., Binta D. A., Diallo M. A., Seck M. C., et al. (2021). High prevalence of asymptomatic Plasmodium infection in Bandafassi, south-east Senegal. Malaria J. 20, 218. doi: 10.1186/s12936-021-03746-7 - DOI - PMC - PubMed
    1. Badiane A., Thwing J., Williamson J., Rogier E., Diallo M. A., Ndiaye D. (2022). Sensitivity and specificity for malaria classification of febrile persons by rapid diagnostic test, microscopy, parasite DNA, histidine-rich protein 2, and IgG: Dakar, Senegal 2015. Int. J. Infect. Dis. 121, 92–97. doi: 10.1016/j.ijid.2022.04.060 - DOI - PMC - PubMed
    1. Bhatt S., Weiss D. J., Cameron E., Bisanzio D., Mappin B., Dalrymple U., et al. (2015). The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature 526, 207–211. doi: 10.1038/nature15535 - DOI - PMC - PubMed
    1. Bousema T., Okell L., Felger I., Drakeley C. (2014). Asymptomatic malaria infections: detectability, transmissibility and public health relevance. Nat. Rev. Microbiol. 12, 833–840. doi: 10.1038/nrmicro3364 - DOI - PubMed
    1. Brooker S., Clarke S. E., Snow R. W., Bundy D. A. P. (2009). Malaria in African schoolchildren: options for control. Trans. R. Soc Trop. Med. Hyg. 103, 1019–1020. doi: 10.1016/j.trstmh.2008.12.004 - DOI - PMC - PubMed

LinkOut - more resources