The online version of this article (doi:10.1186/1475-2875-11-224) contains supplementary material, which is available to authorized users.
Authors declare that they have no conflict of interest.
HMM, PL and JPV designed the study protocol. HMM, RM, PM and GI supervised activities on the field. HMM performed the statistical analysis. HMM, PL and JPV wrote the first draft of the manuscript. All authors read and approved the final version.
Despite some problems related to accuracy and applicability, malaria rapid diagnostic tests (RDTs), are currently considered the best option in areas with limited laboratory services for improving case management and reducing over-treatment. However, their performance must be established taking into the account the particularities of each endemic area. In the Democratic Republic of Congo, the validity of Optimal-IT® and Paracheck-Pf®, respectively based on the detection of lactate dehydrogenase and histidine-rich protein-2, was assessed at primary health care level (PHC).
This was a two-stage cluster randomized survey, conducted in one health centre in 12 health zones in Kinshasa city. All patients with malaria presumptive diagnosis were eligible. Gold standard was microscopy performed by experts from the parasitology unit, Kinshasa University.
624 patients were enrolled. 53.4% (95% CI: 49.4-57.3) owed a bed net, obtained in 74.5% of cases (95% CI: 69.4-79.1) through community-based distribution by the National Malaria Control Programme. Microscopy expert reading confirmed 123 malaria cases (19.7%; 95% CI: 16.7-23.1). Overall sensitivity were 79.7% (95% CI: 72.4-86.8), 87.8% (95% CI: 81.9-93.6) and 86.2% (95% CI: 79.9-92.3), respectively, for Optimal-IT®, Paracheck-Pf® and microscopy performed at PHC. Specificity was 97.0% (95% CI: 95.5-98.5), 91.6% (95% CI: 89.1-94.0) and 49.1% (95% CI: 44.7-53.4). The proportion of confirmed cases seemed similar in under-fives compared to others. Any treatment prior to the current visit was a predictor for malaria (AOR: 2.3; 95% CI: 1.5-3.5), but not malaria treatment (AOR: 0.87; 95% CI: 0.4-1.8). Bed net ownership tended to protect against malaria (AOR: 0.67; 95% CI: 0.45-0.99).
Although microscopy is considered as the "gold standard" for malaria diagnosis at point of care level, this study showed that its accuracy may not always be satisfactory when performed in health centres.
Authors’ original file for figure 112936_2012_2202_MOESM1_ESM.pdf
White NJ: Delaying antimalarial drug resistance with combination chemotherapy. Parassitologia. 1999, 41: 301-308. PubMed
WHO: Guidelines for the treatment of malaria. 2010, World Health Organization, Geneva
WHO: World malaria report 2009. 2009, World Health Organization, Geneva
WHO: Report of WHO technical consultation. The role of laboratory diagnosis to support malaria disease management: focus on the use of rapid diagnostic tests in areas of high transmission. 2006, World Health Organization, Geneva
de Oliveira AM, Skarbinski J, Ouma PO, Kariuki S, Barnwell JW, Otieno K, Onyona P, Causer LM, Laserson KF, Akhwale WS, Slutsker L, Hamel M: Performance of malaria rapid diagnostic tests as part of routine malaria case management in Kenya. Am J Trop Med Hyg. 2009, 80: 470-474. PubMed
Ansah EK, Narh-Bana S, Epokor M, Akanpigbiam S, Quartey AA, Gyapong J, Whitty JM: Rapid testing for malaria in settings where microscopy is available and peripheral clinics where only presumptive treatment is available: a randomised controlled trial in Ghana. BMJ. 2010, 340: c930-10.1136/bmj.c930. PubMedCentralCrossRefPubMed
Rafael ME, Taylor T, Magill A, Lim YW, Girosi F, Allan R: Reducing the burden of childhood malaria in Africa: the role of improved. Nature. 2006, 23 (Suppl 1): 39-48. CrossRef
Shillcutt SD, Morel CM, Coleman PG, Mills AJ, Goodman CA: Cost-effectiveness of malaria diagnosis in sub-Saharan Africa: the role of rapid diagnostic tests in rural settings with high Plasmodium falciparum transmission. Bull World Health Organ. 2008, 86: 101-110. 10.2471/BLT.07.042259. PubMedCentralCrossRefPubMed
WHO: Malaria rapid diagnostic test performance: Results of WHO product testing of malaria RDTs: Round 3 (2010-2011). 2011, World Health Organization, Geneva
Hance P, Garnotel E, De Pina JJ, Vedy S, Ragot C, Chadli M, Morillon M: Rapid immunochromatographic tests for detection of malaria: principles and strategies for use. Med Trop. 2005, 65: 389-393.
Kyabayinze DJ, Tibenderana JK, Odong GW, Rwakimari JB, Counihan H: Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J. 2008, 7: 221-10.1186/1475-2875-7-221. PubMedCentralCrossRefPubMed
Singh N, Shukla MM: Field evaluation of posttreatment 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. 2002, 66: 314-316. PubMed
Tjitra E, Suprianto S, Dyer ME, Currie BJ, Anstey NM: 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. 2001, 65: 593-598. PubMed
Oduola AM, Omitowoju GO, Sowunmi A, Makler MT, Falade CO, Kyle DE, Fehintola FA, Ogundahunsi OA, Piper RC, Schuster BG, Milhous WK: Plasmodium falciparum: evaluation of lactate dehydrogenase in monitoring therapeutic responses to standard antimalarial drugs in Nigeria. Exp Parasitol. 1997, 87: 283-289. 10.1006/expr.1997.4251. CrossRefPubMed
Piper R, Lebras J, Wentworth L, Hunt-Cooke A, Houze S, Chiodini P, Makler M: Immunocapture diagnostic assays for malaria using Plasmodium lactate dehydrogenase (pLDH). Am J Trop Med Hyg. 1999, 60: 109-118. PubMed
Tarimo DS, Minjas JN, Bygbjerg IC: 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. 2001, 95: 437-444. 10.1080/13648590120068971. CrossRefPubMed
WHO: Basic malaria microscopy: Part I Learner' s guide; Part II tutor's guide. 1991, World Health Organization, Geneva
WHO: Informal Consultation on Field Trials and Quality assurance on Malaria Rapid Diagnosis Tests. Malaria Rapid Diagnosis: Making it work. 2003, World Health Organization Regional Office for the Western Pacific, Manila
WHO: New perspectives Malaria Diagnosis. Report of a joint WHO/USAID informal consultation, 25-27 October 1999. 2000, World Health Organization, Geneva
Ashley EA, Touabi M, Ahrer M, Hutagalung R, Htun K, Luchavez J, Dureza C, Proux S, Leimanis M, Lwin MM, Koscalona A, Comte E, Hamade P, Page AL, Nosten F, Guerin PJ: Evaluation of three parasite lactate dehydrogenase-based rapid diagnostic tests for the diagnosis of falciparum and vivax malaria. Malar J. 2009, 8: 241-10.1186/1475-2875-8-241. PubMedCentralCrossRefPubMed
WHO: Malaria microscopy quality assurance manual version 1. 2009, World Health Organization, Geneva
de Macedo OA, Wolkon A, Krishnamurthy R, Erskine M, Crenshaw DP, Roberts J, Saủte F: Ownership and usage of insecticide-treated bed nets after free distribution via a voucher system in two provinces of Mozambique. Malar J. 2010, 9: 222-10.1186/1475-2875-9-222. CrossRef
- Accuracy of malaria rapid diagnosis test Optimal-IT® in Kinshasa, the Democratic Republic of Congo
Hypolite Mavoko Muhindo
Patrick M Mitashi
Jean-Pierre Van Geertruyden
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II