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World Health Organization, 2015. World Malaria Report. Geneva, Switzerland: WHO.
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Aydin-Schmidt B, Mubi M, Morris U, Petzold M, Ngasala BE, Premji Z, Björkman A, Mårtensson A, 2013. Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy. Malar J 12: 349.
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Estimating the Added Utility of Highly Sensitive Histidine-Rich Protein 2 Detection in Outpatient Clinics in Sub-Saharan Africa
Mateusz M. Plucinski
Mateusz M. Plucinski
Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Eric Rogier
Eric Rogier
Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Pedro Rafael Dimbu
Pedro Rafael Dimbu
National Malaria Control Program, Ministry of Health, Luanda, Angola
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Filomeno Fortes
Filomeno Fortes
National Malaria Control Program, Ministry of Health, Luanda, Angola
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Eric S. Halsey
Eric S. Halsey
Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Michael Aidoo
Michael Aidoo
Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Most malaria testing is by rapid diagnostic tests (RDTs) that detect Plasmodium falciparum histidine-rich protein 2 (HRP2). Recently, several RDT manufacturers have developed highly sensitive RDTs (hsRDTs), promising a limit of detection (LOD) orders of magnitude lower than conventional RDTs. To model the added utility of hsRDTs, HRP2 concentration in Angolan outpatients was measured quantitatively using an ultrasensitive bead-based assay. The distribution of HRP2 concentration was bimodal in both afebrile and febrile patients. The conventional RDT was able to detect 81% of all HRP2-positive febrile patients and 52–77% of HRP2-positive afebrile patients. The added utility of hsRDTs was estimated to be greater in afebrile patients, where an hsRDT with a LOD of 200 pg/mL would detect an additional 50–60% of HRP2-positive persons compared with a conventional RDT with a LOD of 3,000 pg/mL. In febrile patients, the hsRDT would detect an additional 10–20% of cases. Conventional RDTs already capture the vast majority of symptomatic HRP2-positive individuals, and hsRDTs would have to reach a sufficiently low LOD approaching 200 pg/mL to provide added utility in identifying HRP2-positive, asymptomatic individuals.
Author Notes
Authors’ addresses: Mateusz M. Plucinski, Eric Rogier, Eric S. Halsey, and Michael Aidoo, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: mplucinski@cdc.gov, erogier@cdc.gov, ehalsey@cdc.gov, and maidoo@cdc.gov. Pedro Rafael Dimbu and Filomeno Fortes, National Malaria Control Program, Ministry of Health, Luanda, Angola, E-mails: rafaeldimbu1@gmail.com and filomenofortes@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2010. Guidelines for the Treatment of Malaria, 2nd edition. Geneva, Switzerland: WHO.
-
2.
World Health Organization, 2015. World Malaria Report. Geneva, Switzerland: WHO.
-
3.
World Health Organization, 2015. Malaria Rapid Diagnostic Test Performance. Results of WHO Product Testing of Malaria RDTs: Round 6 (2014-2015). Geneva, Switzerland: WHO.
-
4.
Plucinski MM et al.., 2017. Evaluating malaria case management at public health facilities in two provinces in Angola. Malar J 16: 186.
-
5.
Rogier E et al.., 2017. Bead based immunoassay allows sub-picogram detection of histidine-rich protein 2 from Plasmodium falciparum and estimates reliability of malaria rapid diagnostic tests. PLoS One 12: e0172139.
-
6.
Kyabayinze DJ, Tibenderana JK, Odong GW, Rwakimari JB, Counihan H, 2008. Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J 7: 221.
-
7.
Aydin-Schmidt B, Mubi M, Morris U, Petzold M, Ngasala BE, Premji Z, Björkman A, Mårtensson A, 2013. Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy. Malar J 12: 349.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 639 | 609 | 29 |
| Full Text Views | 337 | 18 | 1 |
| PDF Downloads | 122 | 8 | 1 |