Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

BACKGROUND: Rapid diagnostic tests (RDTs) are immune chromatographic tests targeting antigens of one or more Plasmodium species and offer the potential to extend accurate malaria diagnosis in endemic areas. In this study, the performance of Plasmodium falciparum-specific histidine-rich protein-2 (Pf...

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Main Authors: Tiono, Alfred B, Ouédraogo, Alphonse, Diarra, Amidou, Coulibaly, Sam, Soulama, Issiaka, Konaté, Amadou T, Barry, Aïssata, Mukhopadhyay, Amitava, Sirima, Sodiomon B, Hamed, Kamal
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Idioma:Inglês
Publicado em: BioMed Central 2014
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Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC3925413/
https://ncbi.nlm.nih.gov/pubmed/24467946
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1186/1475-2875-13-30
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spelling pubmed-39254132014-02-16 Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso Tiono, Alfred B Ouédraogo, Alphonse Diarra, Amidou Coulibaly, Sam Soulama, Issiaka Konaté, Amadou T Barry, Aïssata Mukhopadhyay, Amitava Sirima, Sodiomon B Hamed, Kamal Malar J Research BACKGROUND: Rapid diagnostic tests (RDTs) are immune chromatographic tests targeting antigens of one or more Plasmodium species and offer the potential to extend accurate malaria diagnosis in endemic areas. In this study, the performance of Plasmodium falciparum-specific histidine-rich protein-2 (PfHRP-2) RDT in the detection of asymptomatic carriers from a hyperendemic region of Burkina Faso was compared with microscopy to gain further insight on its relevance in community-based interventions. METHODS: The performance of HRP-2 test was evaluated in terms of sensitivity, specificity, positive and negative predictive values, discordant values, likelihood ratios, accuracy, and precision using microscopy as the 'gold standard’. This analysis was carried out in a controlled, parallel, cluster-randomized (18 clusters; 1:1) study in children and adults. The effect of systematic treatment of P. falciparum asymptomatic carriers during three consecutive monthly community screening campaigns on the incidence of symptomatic malaria episodes over a 12-month period was compared with no treatment of asymptomatic carriers. RESULTS: Sensitivity of HRP-2 test in asymptomatic carriers was higher in campaign 1 (92.4%) when compared to campaign 2 (84.0%) and campaign 3 (77.8%). The sensitivity of HRP-2 test increased as parasite density increased across all the age groups. Highest sensitivity (≥97.0%) was recorded at parasite densities of 1,000-4,999/μl, except for children aged 10 to 14 years. The specificity of HRP-2 test was comparable across age groups and highest in campaign 3 (95.9%). The negative predictive values were high across the three campaigns (≥92.7%) while the positive predictive values ranged from 23.2 to 73.8%. False-positive and false-negative rates were high in campaign 1 and campaign 3, respectively. CONCLUSION: The performance of HRP-2 test in detecting asymptomatic carriers of P. falciparum varied by age and parasite density. Although the use of HRP-2 test is beneficial for the diagnosis of acute malaria, its low sensitivity in screening asymptomatic carriers may limit its utility in pre-elimination interventional settings. The use of a practical and more sensitive test such as loop-mediated isothermal amplification in combination with a cost effective HRP-2 test may be worth exploring in such settings. BioMed Central 2014-01-27 /pmc/articles/PMC3925413/ /pubmed/24467946 http://dx.doi.org/10.1186/1475-2875-13-30 Text en Copyright © 2014 Tiono et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
institution US NLM
collection PubMed Central
language Inglês
format Artigo
topic Research
spellingShingle Research
Tiono, Alfred B
Ouédraogo, Alphonse
Diarra, Amidou
Coulibaly, Sam
Soulama, Issiaka
Konaté, Amadou T
Barry, Aïssata
Mukhopadhyay, Amitava
Sirima, Sodiomon B
Hamed, Kamal
Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
description BACKGROUND: Rapid diagnostic tests (RDTs) are immune chromatographic tests targeting antigens of one or more Plasmodium species and offer the potential to extend accurate malaria diagnosis in endemic areas. In this study, the performance of Plasmodium falciparum-specific histidine-rich protein-2 (PfHRP-2) RDT in the detection of asymptomatic carriers from a hyperendemic region of Burkina Faso was compared with microscopy to gain further insight on its relevance in community-based interventions. METHODS: The performance of HRP-2 test was evaluated in terms of sensitivity, specificity, positive and negative predictive values, discordant values, likelihood ratios, accuracy, and precision using microscopy as the 'gold standard’. This analysis was carried out in a controlled, parallel, cluster-randomized (18 clusters; 1:1) study in children and adults. The effect of systematic treatment of P. falciparum asymptomatic carriers during three consecutive monthly community screening campaigns on the incidence of symptomatic malaria episodes over a 12-month period was compared with no treatment of asymptomatic carriers. RESULTS: Sensitivity of HRP-2 test in asymptomatic carriers was higher in campaign 1 (92.4%) when compared to campaign 2 (84.0%) and campaign 3 (77.8%). The sensitivity of HRP-2 test increased as parasite density increased across all the age groups. Highest sensitivity (≥97.0%) was recorded at parasite densities of 1,000-4,999/μl, except for children aged 10 to 14 years. The specificity of HRP-2 test was comparable across age groups and highest in campaign 3 (95.9%). The negative predictive values were high across the three campaigns (≥92.7%) while the positive predictive values ranged from 23.2 to 73.8%. False-positive and false-negative rates were high in campaign 1 and campaign 3, respectively. CONCLUSION: The performance of HRP-2 test in detecting asymptomatic carriers of P. falciparum varied by age and parasite density. Although the use of HRP-2 test is beneficial for the diagnosis of acute malaria, its low sensitivity in screening asymptomatic carriers may limit its utility in pre-elimination interventional settings. The use of a practical and more sensitive test such as loop-mediated isothermal amplification in combination with a cost effective HRP-2 test may be worth exploring in such settings.
author Tiono, Alfred B
Ouédraogo, Alphonse
Diarra, Amidou
Coulibaly, Sam
Soulama, Issiaka
Konaté, Amadou T
Barry, Aïssata
Mukhopadhyay, Amitava
Sirima, Sodiomon B
Hamed, Kamal
author_facet Tiono, Alfred B
Ouédraogo, Alphonse
Diarra, Amidou
Coulibaly, Sam
Soulama, Issiaka
Konaté, Amadou T
Barry, Aïssata
Mukhopadhyay, Amitava
Sirima, Sodiomon B
Hamed, Kamal
author_sort Tiono, Alfred B
title Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
title_short Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
title_full Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
title_fullStr Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
title_full_unstemmed Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso
title_sort lessons learned from the use of hrp-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of plasmodium falciparum in burkina faso
publisher BioMed Central
publishDate 2014
url https://ncbi.nlm.nih.gov/pmc/articles/PMC3925413/
https://ncbi.nlm.nih.gov/pubmed/24467946
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1186/1475-2875-13-30
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