COMPARISON OF HRP2- AND pLDH-BASED RAPID DIAGNOSTIC TESTS FOR MALARIA WITH LONGITUDINAL FOLLOW-UP IN KAMPALA, UGANDA

HEIDI HOPKINS University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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WILSON KAMBALE University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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MOSES R. KAMYA University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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SARAH G. STAEDKE University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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GRANT DORSEY University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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PHILIP J. ROSENTHAL University of California, San Francisco, San Francisco, California; Makerere University–University of California, San Francisco, Malaria Research Collaboration, Kampala, Uganda; Makerere University, Department of Medicine, Kampala, Uganda; London School of Hygiene & Tropical Medicine, London, United Kingdom

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Presumptive treatment of malaria results in significant overuse of antimalarials. Malaria rapid diagnostic tests (RDTs) may offer a reliable alternative for case management, but the optimal RDT strategy is uncertain. We compared the diagnostic accuracy of histidine-rich protein 2 (HRP2)- and plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as the gold standard, in a longitudinal study of 918 fever episodes over an 8-month period in a cohort of children in Kampala, Uganda. Sensitivity was 92% for HRP2 and 85% for pLDH, with differences primarily due to better detection with HRP2 at low parasite densities. Specificity was 93% for HRP2 and 100% for pLDH, with differences primarily due to rapid clearance of pLDH antigenemia after treatment of a previous malaria episode. RDTs may provide an effective strategy for improving rational delivery of antimalarial therapy; in Kampala, either test could dramatically decrease inappropriate presumptive treatments.

Author Notes

Reprint requests: H. Hopkins, c/o Makerere University–University of California, San Francisco Malaria Research Collaboration, P.O. Box 7475, Kampala, Uganda, Telephone/Fax: +256-414-540524, E-mail: hhopkins@medsfgh.ucsf.edu.
  • 1

    Chandramohan D, Jaffar S, Greenwood B, 2002. Use of clinical algorithms for diagnosing malaria. Trop Med Int Health 7 :45–52.

  • 2

    Luxemburger C, Nosten F, Kyle DE, Kiricharoen L, Chong-suphajaisiddhi T, White NJ, 1998. Clinical features cannot predict a diagnosis of malaria or differentiate the infecting species in children living in an area of low transmission. Trans R Soc Trop Med Hyg 92 :45–49.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Olivar M, Develoux M, Chegou Abari A, Loutan L, 1991. Presumptive diagnosis of malaria results in a significant risk of mistreatment of children in urban Sahel. Trans R Soc Trop Med Hyg 85 :729–730.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Sowunmi A, Akindele JA, 1993. Presumptive diagnosis of malaria in infants in an endemic area. Trans R Soc Trop Med Hyg 87 :422.

  • 5

    Bell D, Wongsrichanalai C, Barnwell JW, 2006. Ensuring quality and access for malaria diagnosis: how can it be achieved? Nat Rev Microbiol 4 :682–695.

  • 6

    Amexo M, Tolhurst R, Barnish G, Bates I, 2004. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 364 :1896–1898.

  • 7

    Moerman F, Lengeler C, Chimumbwa J, Talisuna A, Erhart A, Coosemans M, D’Alessandro U, 2003. The contribution of health-care services to a sound and sustainable malaria-control policy. Lancet Infect Dis 3 :99–102.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Bloland PB, Kachur SP, Williams HA, 2003. Trends in antimalarial drug deployment in sub-Saharan Africa. J Exp Biol 206 :3761–3769.

  • 9

    Moody A, 2002. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 15 :66–78.

  • 10

    Tjitra E, Suprianto S, Dyer ME, Currie BJ, Anstey NM, 2001. Detection of histidine-rich protein 2 and panmalarial ICT Malaria Pf/Pv test antigens after chloroquine treatment of uncomplicated falciparum malaria does not reliably predict treatment outcome in eastern Indonesia. Am J Trop Med Hyg 65 :593–598.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Singh N, Shukla MM, 2002. Short report: field evaluation of post-treatment sensitivity for monitoring parasite clearance of Plasmodium falciparum malaria by use of the Determine Malaria pf test in central India. Am J Trop Med Hyg 66 :314–316.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Mayxay M, Pukrittayakamee S, Chotivanich K, Looareesuwan S, White NJ, 2001. Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria. Trans R Soc Trop Med Hyg 95 :179–182.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Piper R, Lebras J, Wentworth L, Hunt-Cooke A, Houze S, Chiodini P, Makler M, 1999. Immunocapture diagnostic assays for malaria using Plasmodium lactate dehydrogenase (pLDH). Am J Trop Med Hyg 60 :109–118.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Moody A, Hunt-Cooke A, Gabbett E, Chiodini P, 2000. Performance of the OptiMAL malaria antigen capture dipstick for malaria diagnosis and treatment monitoring at the Hospital for Tropical Diseases, London. Br J Haematol 109 :891–894.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Oduola AM, Omitowoju GO, Sowunmi A, Makler MT, Falade CO, Kyle DE, Fehintola FA, Ogundahunsi OA, Piper RC, Schuster BG, Milhous WK, 1997. Plasmodium falciparum: evaluation of lactate dehydrogenase in monitoring therapeutic responses to standard antimalarial drugs in Nigeria. Exp Parasitol 87 :283–289.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Davis JC, Clark TD, Kemble SK, Talemwa N, Njama-Meya D, Staedke SG, Dorsey G, 2006. Longitudinal study of urban malaria in a cohort of Ugandan children: description of study site, census and recruitment. Malar J 5 :18.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE, 1995. Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. Am J Trop Med Hyg 52 :565–568.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Zwetyenga J, Rogier C, Tall A, Fontenille D, Snounou G, Trape JF, Mercereau-Puijalon O, 1998. No influence of age on infection complexity and allelic distribution in Plasmodium falciparum infections in Ndiop, a Senegalese village with seasonal, mesoendemic malaria. Am J Trop Med Hyg 59 :726–735.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Cattamanchi A, Kyabayinze D, Hubbard A, Rosenthal PJ, Dorsey G, 2003. Distinguishing recrudescence from reinfection in a longitudinal antimalarial drug efficacy study: comparison of results based on genotyping of msp-1, msp-2, and glurp. Am J Trop Med Hyg 68 :133–139.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Snounou G, Viriyakosol S, Jarra W, Thaithong S, Brown KN, 1993. Identification of the four human malaria parasite species in field samples by the polymerase chain reaction and detection of a high prevalence of mixed infections. Mol Biochem Parasitol 58 :283–292.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Nsobya SL, Parikh S, Kironde F, Lubega G, Kamya MR, Rosenthal PJ, Dorsey G, 2004. Molecular evaluation of the natural history of asymptomatic parasitemia in Ugandan children. J Infect Dis 189 :2220–2226.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Bigaillon C, Fontan E, Cavallo JD, Hernandez E, Spiegel A, 2005. Ineffectiveness of the Binax NOW malaria test for diagnosis of Plasmodium ovale malaria. J Clin Microbiol 43 :1011.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Marx A, Pewsner D, Egger M, Nuesch R, Bucher HC, Genton B, Hatz C, Juni P, 2005. Meta-analysis: accuracy of rapid tests for malaria in travelers returning from endemic areas. Ann Intern Med 142 :836–846.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Kilian AH, Kabagambe G, Byamukama W, Langi P, Weis P, von Sonnenburg F, 1999. Application of the ParaSight-F dipstick test for malaria diagnosis in a district control program. Acta Trop 72 :281–293.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Guthmann JP, Ruiz A, Priotto G, Kiguli J, Bonte L, Legros D, 2002. Validity, reliability and ease of use in the field of five rapid tests for the diagnosis of Plasmodium falciparum malaria in Uganda. Trans R Soc Trop Med Hyg 96 :254–257.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Tarimo D, Minjas J, Bygbjerg I, 2001. Malaria diagnosis and treatment under the strategy of the integrated management of childhood illness (IMCI): relevance of laboratory support from the rapid immunochromatographic tests of ICT Malaria P.f./ P.v. and OptiMal. Ann Trop Med Parasitol 95 :437–444.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Jorgensen P, Chanthap L, Rebueno A, Tsuyuoka R, Bell D, 2006. Malaria rapid diagnostic tests in tropical climates: the need for a cool chain. Am J Trop Med Hyg 74 :750–754.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Bojang KA, 1999. The diagnosis of Plasmodium falciparum infection in Gambian children, by field staff using the rapid, manual, ParaSight-F test. Ann Trop Med Parasitol 93 :685–687.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Mayxay M, Newton PN, Yeung S, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ, 2004. Short communication: An assessment of the use of malaria rapid tests by village health volunteers in rural Laos. Trop Med Int Health 9 :325–329.

    • PubMed
    • Search Google Scholar
    • Export Citation
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