Antigen persistence of rapid diagnostic tests in pregnant women in Nanoro, Burkina Faso, and the implications for the diagnosis of malaria in pregnancy

Kattenberg, Johanna H.; Tahita, Christian M.; Versteeg, Inge A. J.; Tinto, Halidou; Traoré‐Coulibaly, Maminata; Schallig, Henk D. F. H.; Mens, Petra F.

doi:10.1111/j.1365-3156.2012.02975.x

Cited by 63Malaria Research and ControlBiosensors and Analytical DetectionVector-borne infectious diseases

Antigen persistence of rapid diagnostic tests in pregnant women in Nanoro, Burkina Faso, and the implications for the diagnosis of malaria in pregnancy

Kattenberg, Johanna H., Tahita, Christian M., Versteeg, Inge A. J., Tinto, Halidou, Traoré‐Coulibaly, Maminata, Schallig, Henk D. F. H., Mens, Petra F.·2012·Tropical Medicine & International Health

DOI 10.1111/j.1365-3156.2012.02975.x

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Abstract

Objectives To evaluate persistence of several Plasmodium antigens in pregnant women after treatment and compare diagnostics during treatment follow‐up. Methods Thirty‐two pregnant women (N = 32) with confirmed malaria infection by a histidine‐rich protein 2 (HRP2)‐based rapid diagnostic test (RDT) and microscopy were followed for 28 days after artemisinin‐based combination therapy (ACT). A Plasmodium lactate dehydrogenase (pLDH)‐based RDT and two ELISAs based on the detection of dihydrofolate reductase–thymidylate synthase (DHFR‐TS) and haeme detoxification protein (HDP) were compared with each other and to RT‐PCR at each visit. Results The mean visit number (95% confidence interval) on which the HRP2‐based RDT was still positive after treatment was 3.4 (2.7–4.1) visits with some patients still positive at day 28. This is significantly later than the pLDH‐based RDT [0.84 (0.55–1.1)], microscopy (median 1, range 1–3), DHFR‐TS‐ELISA [1.7 (1.1–2.3)] and RT‐PCR (median 2, range 1–5) (P < 0.05), but not significantly later than HDP‐ELISA [2.1 (1.6–2.7)]. Lower gravidity and higher parasite density at day 0 resulted in significantly longer positive results with most tests (P < 0.05). Conclusions HRP2 can persist up to 28 days after ACT treatment; therefore, this test is not suitable for treatment follow‐up in pregnant women and can generate problems when using this test during intermittent preventive treatment (IPTp). DHFR‐TS is less persistent than HRP2, making it a potentially interesting target for diagnosis.

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In a recent study, 2 out of 32 parasitemic pregnant women treated with artemisinin combination therapy continued to have detectable HRP2 antigen 28 days post-treatment.
“In a recent study that followed pregnant women after treatment with artemisinin combination therapy [26], 2 out of 32 parasitemic women (diagnosed by BS and HRP2-RDT) continued to have detectable HRP2 antigen 28 days post-treatment [26].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [26]
HRP2-based RDT positivity among pregnant women can persist for up to 28 days after antimalarial drug treatment, especially among women with low gravidity and those with a higher parasite density at enrolment.
“It should be mentioned that HRP2 based RDT positivity among pregnant women can persist for up to 28 days after antimalarial drug treatment, especially among women with low gravidity and those with a higher parasite density at enrolment [14].”
From Reliability of rapid diagnostic test for diagnosing peripheral and placental malaria in an area of unstable malaria transmission in Eastern Sudan (2013) · cites this paper as [14]
There are few published data on the performance of RDT for diagnosing malaria during pregnancy, especially in areas of unstable malaria transmission.
“While RDT have been extensively evaluated in malaria among the non-pregnant population, there are few published data on the performance of RDT for diagnosing malaria during pregnancy, especially in areas of unstable malaria transmission [12-17].”
From Reliability of rapid diagnostic test for diagnosing peripheral and placental malaria in an area of unstable malaria transmission in Eastern Sudan (2013) · cites this paper as [14]

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Authors: Kattenberg, J. H., Tahita, C. M., Versteeg, I. A. J., Tinto, H., Traoré‐Coulibaly, M., Schallig, H. D. F. H., & Mens, P. F.
Affiliations: Royal Tropical Institute (NL)
Institut de Recherche en Sciences de la Santé (BF)
Corresponding author: Kattenberg, Johanna H.
ORCID: Kattenberg, Johanna H.
Tinto, Halidou
Traoré‐Coulibaly, Maminata
Schallig, Henk D. F. H.
Venue: Tropical Medicine & International Health
Publisher: Wiley
Published: 2012-04-02
Volume: 17
Issue: 5
Pages: 550-557
ISSN: 1360-2276 (ISSN-L)
1365-3156
DOI: 10.1111/j.1365-3156.2012.02975.x
OpenAlex: W2112903021
Cited by: 63
References: 33
Citations by year: 2025: 4 · 2024: 2 · 2023: 4 · 2022: 9 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 9 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 5
FWCI: 4.95
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Tropical Medicine & International Health (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Physical Sciences › Engineering › Biomedical Engineering › Biosensors and Analytical Detection
Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
Keywords: malaria in pregnancy, Plasmodium antigens, antigen persistence, HRP-2, pLDH, rapid diagnostic tests, artemisinin-based combination therapy, treatment follow-up, intermittent preventive treatment, gravidity, parasite density
MeSH terms: Adult, Analysis of Variance, Anti-Infective Agents, Antigens, Protozoan, Burkina Faso, Enzyme-Linked Immunosorbent Assay, Female, Follow-Up Studies, Humans, L-Lactate Dehydrogenase, Multienzyme Complexes, Plasmodium falciparum, Pregnancy, Tetrahydrofolate Dehydrogenase, Thymidylate Synthase, Biomarkers, Pregnancy Complications, Parasitic, Protozoan Proteins, Malaria, Falciparum, Treatment Outcome, Artemisinins, Real-Time Polymerase Chain Reaction

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Antigen persistence of rapid diagnostic tests in pregnant women in Nanoro, Burkina Faso, and the implications for the diagnosis of malaria in pregnancy

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