Persistent ICT Malaria P.f/P.v Panmalarial and HRP2 Antigen Reactivity after Treatment of Plasmodium falciparum Malaria Is Associated with Gametocytemia and Results in False-Positive Diagnoses of Plasmodium vivax in Convalescence

Tjitra, Emiliana; Suprianto, Sri; McBroom, James; Currie, Bart J.; Anstey, Nicholas M.

doi:10.1128/jcm.39.3.1025-1031.2001

Cited by 114Malaria Research and ControlBiosensors and Analytical DetectionVector-borne infectious diseases

Persistent ICT Malaria P.f/P.v Panmalarial and HRP2 Antigen Reactivity after Treatment of Plasmodium falciparum Malaria Is Associated with Gametocytemia and Results in False-Positive Diagnoses of Plasmodium vivax in Convalescence

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Tjitra, Emiliana, Suprianto, Sri, McBroom, James, Currie, Bart J., Anstey, Nicholas M.·2001·Journal of Clinical Microbiology

DOI 10.1128/jcm.39.3.1025-1031.2001PMC PMC87868

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Abstract

A problem with rapid Plasmodium falciparum -specific antigen histidine-rich protein 2 (HRP2) detection tests for malaria is the persistence of antigen in blood after the disappearance of asexual-stage parasitemia and clinical symptoms, resulting in false-positive (FP) test results following treatment. The ICT P.f/P.v immunochromatographic test detects both HRP2 and a panmalarial antigen (PMA) found in both P. falciparum and Plasmodium vivax . To examine posttreatment antigen persistence with this test and whether persistent sexual-stage forms (gametocytes) are a cause of FP tests after treatment, we compared serial antigen test results with microscopy results from patients symptomatic with P. falciparum malaria in Indonesia for 28 days following treatment with chloroquine (CQ; n = 66), sulfadoxine-pyrimethamine (SP; n = 36), and artesunate plus sulfadoxine-pyrimethamine (ART + SP; n = 15). Persistent FP antigenemia following SP treatment occurred in 29% (HRP2) and 42% (PMA) of the patients on day 7 and in 10% (HRP2) and 23% (PMA) on day 14. The high rates of persistent HRP2 and PMA antigenemia following CQ and SP treatment were strongly associated with the presence of gametocytemia, with the proportion with gametocytes on day 7 posttreatment being significantly greater in those with FP results than in those with true-negative PMA and HRP2 results. Gametocyte frequency on day 14 post-SP treatment was also greater in those with FP PMA results. Following SP treatment, PMA persisted longer than HRP2, giving an FP diagnosis of P. vivax in up to 16% of patients on day 14, with all FP P. vivax diagnoses having gametocytemia. In contrast, PMA was rapidly cleared following ART + SP treatment in association with rapid clearance of gametocytemia. Gametocytes appear to be an important cause of persistent posttreatment panmalarial antigenemia in areas of endemicity and may also contribute in part to persistent HRP2 antigenemia following treatment.

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An important weakness of RDT-HRP2 tests is the prolonged half-life of HRP-2 antigen, which can be identified in plasma several weeks after parasite clearance and therefore cannot distinguish current from recent infection.
“An important weakness of RDT-HRP2 tests is the prolonged half-life of the antigen. HRP-2 can be identified in plasma samples several weeks after parasite clearance, and therefore cannot be used to distinguish current from recent infection [23–25].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [24]
These shortcomings hinder the use of existing RDTs for managing malaria and for monitoring treatment efficacy.
“These shortcomings hinder the use of existing RDT for managing malaria, and also for monitoring treatment efficacy [23–25].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [24]

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Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy
Aydin-Schmidt, B., Mubi, M., Morris, U., Petzold, M., Ngasala, B., Premji, Z., Björkman, A., & Mårtensson, A. (2013) · Malaria Journal · doi:10.1186/1475-2875-12-349 · Cited by 58 · see citing works
“It has been claimed that especially HRP2 but also LDH are released by immature gametocytes, which may result in persistent positive test results [5,29].”
Performance of three multi-species rapid diagnostic tests for diagnosis of Plasmodium falciparum and Plasmodium vivax malaria in Oromia Regional State, Ethiopia
Ashton, R. A., Kefyalew, T., Tesfaye, G., Counihan, H., Yadeta, D., Cundill, B., Reithinger, R., & Kolaczinski, J. H. (2010) · Malaria Journal · doi:10.1186/1475-2875-9-297 · Cited by 57 · see citing works
“Whilst previous work has shown that some RDT false positives are due to patients with residual gametocytaemia [30], this association was not seen in the current study.”
Result
RAPID DIAGNOSTIC DEVICES FOR MALARIA: FIELD EVALUATION OF A NEW PROTOTYPE IMMUNOCHROMATOGRAPHIC ASSAY FOR THE DETECTION OF PLASMODIUM FALCIPARUM AND NON-FALCIPARUM PLASMODIUM
Wongsrichanalai, C., Arevalo, I., Laoboonchai, A., Yingyuen, K., Miller, R. S., Magill, A. J., Forney, J. R., & Gasser, R. A. (2003) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2003.69.26 · Cited by 54 · see citing works
A comparison of three diagnostic techniques for malaria: a rapid diagnostic test (NOW®Malaria), PCR and microscopy
GATTI, S., Gramegna, M., Bisoffi, Z., Raglio, A., Gulletta, M., Klersy, C., Bruno, A., Maserati, R., Madama, S., Scaglia, M., et al. (2007) · Annals of Tropical Medicine and Parasitology · doi:10.1179/136485907x156997 · Cited by 49 · see citing works
“…recorded as smear-negative, were found RDT-positive could reflect the prolonged persistence of antigen reactivity after effective therapy (Gatti et al., 2002), or subpatent infection, with parasitaemias below those detectable by microscopy (Tjitra et al., 2001; Iqbal et al., 2004; WHO, 2005).”
Background
Detection and Species Identification of Malaria Parasites by Isothermal tHDA Amplification Directly from Human Blood without Sample Preparation
Li, Y., Kumar, N., Gopalakrishnan, A. M., Ginocchio, C. C., Manji, R., Bythrow, M., Lemieux, B., & Kong, H. (2013) · Journal of Molecular Diagnostics · doi:10.1016/j.jmoldx.2013.05.005 · Cited by 48 · see citing works
Quantitative detection of Pf HRP2 in saliva of malaria patients in the Philippines
Fung, A. O., Damoiseaux, R. D., Grundeen, S., Panes, J. L., Horton, D. H., Judy, J. W., & Moore, T. B. (2012) · Malaria Journal · doi:10.1186/1475-2875-11-175 · Cited by 46 · see citing works
“utility of PfHRP2 in monitoring patient response to antimalarial therapy is limited by the persistence of reactive circulating antigen for several weeks post-treatment [18].”
A guide for diagnostic evaluations
Peeling, R. W. W., Smith, P. G., & Bossuyt, P. M. (2006) · Nature Reviews Microbiology · doi:10.1038/nrmicro1522 · Cited by 46 · see citing works
Evaluation of rapid diagnostic tests for malaria case management in Gabon
Mawili-Mboumba, D. P., Bouyou-Akotet, M. K., Ngoungou, E. B., & Kombila, M. (2009) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2009.09.011 · Cited by 41 · see citing works
“The high Se of OptiMAL-IT® is concordant with that found in others studies (Ratsimbasoa et al., 2007; Tarimo et al., 2001; Valéa et al., 2009).”
MethodResult
Field evaluation of HRP2 and pan pLDH-based immunochromatographic assay in therapeutic monitoring of uncomplicated falciparum malaria in Myanmar
Nyunt, M. H., Kyaw, M. P., Win, K. K., Myint, K. M., & Nyunt, K. M. (2013) · Malaria Journal · doi:10.1186/1475-2875-12-123 · Cited by 38 · see citing works
Multicentre study, in patients with imported malaria, on the sensitivity and specificity of a dipstick test (ICT Malaria P.f./P.v.TM) compared with expert microscopy
GATTI, S., Bernuzzi, A. M., Bisoffi, Z., Raglio, A., & Scaglia, M. (2002) · Annals of Tropical Medicine and Parasitology · doi:10.1179/000349802125000457 · Cited by 38 · see citing works
“The other cleared the parasitaemias or reduced them to levels below those detectable by routinetwo cases of detected mixed infection (one case with P. vivax plus P. ovale and one with microscopy (Tjitra et al., 2001).”
Background
Production and characterization of specific monoclonal antibodies binding the Plasmodium falciparum diagnostic biomarker, histidine-rich protein 2
Leow, C. H., Jones, M. L., Cheng, Q., Mahler, S. M., & McCarthy, J. S. (2014) · Malaria Journal · doi:10.1186/1475-2875-13-277 · Cited by 36 · see citing works
“This protein is abundantly expressed in the red cell, released during rupture of infected red cells and can remain in the blood for up to 28 days after the initiation of anti-malarial therapy, making it an excellent biomarker for diagnosis [7-9].”
Background
Challenges in diagnosing paediatric malaria in Dar es Salaam, Tanzania
Strøm, G. E., Haanshuus, C. G., Fataki, M. R., Langeland, N., & Blomberg, B. (2013) · Malaria Journal · doi:10.1186/1475-2875-12-228 · Cited by 35 · see citing works
“Gametocytes may survive antimalarial treatment with ACT and continue to circulate more than 28 days after completed treatment, without any clinical symptoms [34,35].”
Background
PfHRP2-PfHRP3 diversity among Kenyan isolates and comparative evaluation of PfHRP2/pLDH malaria RDT with microscopy and nested PCR methodologies
Nderu, D., Kimani, F. T., Thiong’o, K., Akinyi, M. V., Karanja, E., Meyer, C. G., & Velavan, T. P. (2018) · Parasitology International · doi:10.1016/j.parint.2018.08.007 · Cited by 33 · see citing works
How Do We Best Diagnose Malaria in Africa?
Rosenthal, P. J. (2012) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2012.11-0619 · Cited by 34 · see citing works
“In addition, HRP2 can circulate for an extended period of time after an infection has been cleared(4) and is also expressed by gametocytes.(5) Thus, false-positive tests may be caused by recent but not current infection.”
Background
Clearance dynamics of lactate dehydrogenase and aldolase following antimalarial treatment for Plasmodium falciparum infection
Pluciński, M. M., McElroy, P. D., Dimbu, P. R., Fortes, F., Nace, D., Halsey, E. S., & Rogier, E. W. (2019) · Parasites & Vectors · doi:10.1186/s13071-019-3549-x · Cited by 33 · see citing works
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.
Tjitra, E., Suprianto, S., Dyer, M. E., Currie, B. J., & Anstey, N. M. (2001) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2001.65.593 · Cited by 31 · see citing works
Self-citation
A guide for diagnostic evaluations
Peeling, R. W. W., Smith, P. G., & Bossuyt, P. M. (2010) · Nature Reviews Microbiology · doi:10.1038/nrmicro1522z · Cited by 31 · see citing works
Quality and reliability of current malaria diagnostic methods
Haditsch, M. (2004) · Travel Medicine and Infectious Disease · doi:10.1016/j.tmaid.2004.03.001 · Cited by 30 · see citing works
Laboratory Detection of Malaria Antigens: a Strong Tool for Malaria Research, Diagnosis, and Epidemiology
Pluciński, M. M., Aidoo, M., & Rogier, E. W. (2021) · Clinical Microbiology Reviews · doi:10.1128/cmr.00250-20 · Cited by 29 · see citing works
“The persistence of HRP2 antigenemia has been noted since the initial rapid diagnostic test (RDT) field trials (78), and the lower detection limits of the new generation of laboratory tests have revealed a long duration of persistence of HRP2 in human blood.”
Background
Use of HRP-2-based rapid diagnostic test for Plasmodium falciparum malaria: assessing accuracy and cost-effectiveness in the villages of Dielmo and Ndiop, Senegal
Ly, A. B., Tall, A., Perry, R. T., Baril, L., Badiane, A., Faye, J., Rogier, C., Touré, A., Sokhna, C., Trape, J., et al. (2010) · Malaria Journal · doi:10.1186/1475-2875-9-153 · Cited by 29 · see citing works
“Another cause of false positive results with HRP-2based tests found in Dielmo is the presence of early gametocytes [47,48].”
Targeted Amplicon Deep Sequencing for Monitoring Antimalarial Resistance Markers in Western Kenya
Osoti, V., Akinyi, M. Y., Wamae, K., Kimenyi, K. M., de Laurent, Z. R., Ndwiga, L., Gichuki, P. M., Okoyo, C. O., Kepha, S., Mwandawiro, C. S., et al. (2022) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01945-21 · Cited by 23 · see citing works
Implementation of a malaria rapid diagnostic test in a rural setting of Nanoro, Burkina Faso: from expectation to reality
Kiemdé, F., Tahita, M. C., Bonko, M. D. A., Mens, P. F., Tinto, H., van Hensbroek, M. B., & Schallig, H. D. F. H. (2018) · Malaria Journal · doi:10.1186/s12936-018-2468-1 · Cited by 22 · see citing works
Malaria
White, N. J. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-4470-3.50077-x · Cited by 21 · see citing works
Concordancia entre gota gruesa, inmunocromatografía y reacción en cadena de la polimerasa para el diagnóstico de malaria
Montoya, A. E. A., Menco, J., Osorio, N., Zuluaga, M. A., Duque, J., Torres, G., & Restrepo, M. (2008) · Biomédica · doi:10.7705/biomedica.v28i2.96 · Cited by 17 · see citing works
Evaluation of PCR To Monitor Plasmodium falciparum Treatment Efficacy in a Nonendemicity Setting
Kamaliddin, C., Joste, V., Hubert, V., Kendjo, É., Argy, N., & Houzé, S. (2019) · Journal of Clinical Microbiology · doi:10.1128/jcm.01080-19 · Cited by 15 · see citing works
“In addition, the nonpathogenic sexual forms of the parasite (gametocytes) have been known to secrete HRP-2 (13, 21), which could induce positive test results after clearance of asexual forms.”
BackgroundResult
A Case of Hyper-reactive Malarial Splenomegaly. The Role of Rapid Antigen-detecting and PCR-based Tests
Mothe, B., López-Contreras, J., Torres, O. H., Muñoz, C., Domingo, P., & Gurguí, M. (2007) · Infection · doi:10.1007/s15010-007-6025-z · Cited by 15 · see citing works
“mutation or deletion within the hrpii gene [6, 10].”
Background
Malaria rapid diagnostic test and Giemsa – stained peripheral blood smear discrepancies in the diagnosis of Plasmodium ovale infection in New England
Aregawi, S., Li, L., & Miraglia, C. M. (2017) · American Society for Clinical Laboratory Science · doi:10.29074/ascls.30.2.75 · Cited by 14 · see citing works
The in-vivo dynamics of Plasmodium falciparum HRP2: implications for the use of rapid diagnostic tests in malaria elimination
Marquart, L., Webb, L., O'Rourke, P. K., Gatton, M. L., Hsiang, M. S., Kalnoky, M., Jang, I. K., Ntuku, H., Mumbengegwi, D. R., Domingo, G. J., et al. (2022) · Malaria Journal · doi:10.1186/s12936-022-04245-z · Cited by 13 · see citing works
“However, PfHRP2 is known to be produced by gametocytes in a stage-specific manner [42] and gametocytaemia has been associated with false positivity in RDTs based on PfHRP2 and pan-malarial antigens, particularly among patients treated with chloroquine and sulfadoxine–pyrimethamine compared with artesunate [7].”
No asymptomatic malaria parasitaemia found among 108 young children at one health facility in Dar es Salaam, Tanzania
Strøm, G. E., Tellevik, M. G., Fataki, M. R., Langeland, N., & Blomberg, B. (2013) · Malaria Journal · doi:10.1186/1475-2875-12-417 · Cited by 14 · see citing works
“Asymptomatic malaria with persisting gametocytes is known to be frequent, for example, post-treatment [6,30].”
Background
Quality assurance of malaria rapid diagnostic tests used for routine patient care in rural Tanzania: microscopy versus real-time polymerase chain reaction
Masanja, I. M., McMorrow, M., Maganga, M. B., Sumari, D., Udhayakumar, V., McElroy, P. D., Kachur, S. P., & Lucchi, N. W. (2015) · Malaria Journal · doi:10.1186/s12936-015-0597-3 · Cited by 14 · see citing works
“In addition, studies in other malaria endemic areas have associated false positivity of RDTs with presence of gametocytes in blood [27] and acute schistosomiasis [28].”
Background
Evaluación de la prueba rápida inmunocromatográfica Binax NOW® ICT Pf/Pv para el diagnóstico del paludismo en un área endémica de Colombia
Pabón, A., Álvarez, L. G., Yánez, J., Céspedes, C., Rodríguez-Álvarez, Y., Restrepo, A. M., & Blair, S. (2007) · Biomédica · doi:10.7705/biomedica.v27i2.218 · Cited by 12 · see citing works
“Por otra parte, se han reportado falsos negativos en altas parasitemias debido al fenómeno prozona por la gran antigenemia (26,27) o por la ausencia del gen que codifica para la proteína HRP –II en un 2% a 3 % de los parásitos de la malaria (16).”
Background
Slow clearance of histidine-rich protein-2 in Gabonese with uncomplicated malaria
Calle, C. L., Schaumburg, F., Rieck, T., Nkoma, A.-M., Salazar, P. M. D., Breil, S., Behringer, J., Kremsner, P. G., Mordmüller, B. G., & Fendel, R. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.00994-24 · Cited by 13 · see citing works
Persistence of Plasmodium falciparum HRP-2 antigenaemia after artemisinin combination therapy is not associated with gametocytes
Oulton, T., Mahamar, A., Sanogo, K., Diallo, M., Youssouf, A., Niambele, S. M., Samaké, S., Keita, S., Sinaba, Y., Sacko, A., et al. (2022) · Malaria Journal · doi:10.1186/s12936-022-04387-0 · Cited by 11 · see citing works
“Residual sexual stage parasites have been shown to be both associated [25] and unassociated [26] with RDT positivity, though such studies lack sufficiently sensitive experimental approaches to drawn firm conclusions.”
Background
Point-of-care testing for malaria outbreak management
Ratnawati, R., Hatta, M., & Smits, H. L. (2008) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2008.04.018 · Cited by 11 · see citing works
Performance of rapid diagnostic test, light microscopy, and polymerase chain reaction in pregnant women with asymptomatic malaria in Nigeria
Adebusuyi, S. A., Olorunfemi, A. B., Fagbemi, K., Nderu, D., Amoo, A. O. J., Thomas, B. N., Velavan, T. P., & Ojurongbe, O. (2024) · IJID Regions · doi:10.1016/j.ijregi.2024.100416 · Cited by 14 · see citing works
“Furthermore, PfHRP2 persistence could be extended further by increased antigen production by gametocytes, particularly, when gameto-cyte production is elevated after induction by IPTp-SP [ 23 ].”
Background
Malaria dipsticks beneficial for IMCI in Cambodia
Rimon, M., Kheng, S., Hoyer, S., Thach, V., Ly, S., Permin, A., & Pièche, S. (2003) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.2003.01045.x · Cited by 10 · see citing works
Evaluación de la prueba ICT malaria P.f./P.v. (AMRAD®) para la detección de P. falciparum y P. vivax en una zona endémica de la amazonía peruana
Llanos-Zavalaga, F., Villacorta, J., Roberto Reyes, L., Lecca, L. W., Daniel Mendoza, R., Pérez, J. M., & H., J. E. V. (2002) · Americanae (AECID Library) · doi:10.17843/rpmesp.2002.191.783 · Cited by 9 · see citing works
Cytoplasmic and periplasmic expression of recombinant shark VNAR antibody in Escherichia coli
Leow, H. C., Fischer, K., Leow, C. Y., Braet, K., Cheng, Q., & McCarthy, J. S. (2019) · Preparative Biochemistry & Biotechnology · doi:10.1080/10826068.2019.1566145 · Cited by 8 · see citing works
Analysis of Nematode Motion Using an Improved Light-Scatter Based System
Nutting, C., Eversole, R., Blair, K., Specht, S., Nutman, T., Klion, A., Wanji, S., Boussinesq, M., & Mackenzie, C. (2015) · PLoS Neglected Tropical Diseases · doi:10.1371/journal.pntd.0003523 · Cited by 9 · see citing works
Reliability of rapid diagnostic tests in diagnosing pregnancy and infant-associated malaria in Nigeria
Oyeyemi, O. T., Sode, O. J., Adebayo, O. D., & Mensah–Agyei, G. O. (2015) · Journal of Infection and Public Health · doi:10.1016/j.jiph.2015.11.012 · Cited by 7 · see citing works
Diagnosis of malaria in pregnancy: A comparison of microscopy with rapid diagnostic tests
Si, U., Enwuru, C. P., & Egbuobi, R. (2013) · Microbiology Research International · Cited by 5 · see citing works
LABORATORY EVALUATION OF THE ICT MALARIA P.F./P.V. IMMUNOCHROMATOGRAPHIC TEST FOR DETECTING THE PANMALARIAL ANTIGEN USING A RODENT MALARIA MODEL
Arai, M., Ishii, A., & Matsuoka, H. (2004) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2004.70.139 · Cited by 5 · see citing works
“Moreover, the lower sensitivity of the ICT PMA test in a study of febrile returned travelers(21) likely reflects the short duration of infection in non-immune travelers relative to residents of endemic areas.(13,14) In endemic areas, a degree of immunity results in”
Background
A guide for diagnostic evaluations
Peeling, R. W. W., Smith, P. G., & Bossuyt, P. M. (2007) · Nature Reviews Microbiology · doi:10.1038/nrmicro1522x · Cited by 5 · see citing works
Using Reference Quantitative Polymerase Chain Reaction to Assess the Clinical Performance of the Paracheck-Pf® Rapid Diagnostic Test in a Field Setting in Uganda
Mitran, C. J., Mbonye, A. K., Hawkes, M., & Yanow, S. K. (2018) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.18-0112 · Cited by 4 · see citing works
“Several studies also showed that RDTs can detect HRP2 produced by circulating gametocytes.(18,19) If chronic submicroscopic infections or sexual stages of P.”
Background
A guide for diagnostic evaluations
Peeling, R. W. W., Smith, P. G., & Bossuyt, P. M. (2008) · Nature Reviews Microbiology · doi:10.1038/nrmicro1522y · Cited by 4 · see citing works
Performance of a Histidine Rich Protein-2 Based (First Response) and a p-Lactate Dehydrogenase-based (Optimal) Rapid Diagnostic Test for Diagnosis of Malaria in Patients With Pediatric Sickle Cell Disease
Adjei, G. O., Sulley, A. M., Goka, B. Q., Enweronu-Laryea, C. C., Renner, L. A., Alifrangis, M., & Kurtzhals, J. A. L. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab977 · Cited by 3 · see citing works
Field and laboratory evaluation of Abbott-Bioline™ Malaria Ag Pf/Pv RDT performance in a high-transmission setting: contrasting results with a low-endemic area
Fenomanana, J., Ravoavy, A., Rakotoarisoa, M. A., Platon, L., Wade, A., Chala, B., Tibiri, Y. N. G., Muller, A., Thiebaut, L., Caspar, E., et al. (2026) · Malaria Journal · doi:10.1186/s12936-026-05869-1 · Cited by 2 · see citing works
“These false positives likely reflect HRP2 antigen persistence following treatment, a well-documented phenomenon [20–24].”
Correlating quantitative real-time PCR to rapid diagnostic test and RNA transcript expression in isolated gametocytemia and asexual parasitemia of Plasmodium falciparum malaria
Lau, R., Phuong, M., Ralevski, F., & Boggild, A. K. (2015) · Tropical Diseases Travel Medicine and Vaccines · doi:10.1186/s40794-015-0008-3 · Cited by 2 · see citing works
“Both RDT and PCR can remain positive long after successful treatment of malaria, and resolution of clinical symptoms [17].”
Background
Intérêt du test Paracheck Pf® pour le diagnostic de paludisme à Plasmodium falciparum
Bourée, P., & Alex, S. (2008) · Revue Francophone des Laboratoires · doi:10.1016/s1773-035x(08)70187-4 · Cited by 2 · see citing works
LABORATORY DIAGNOSIS OF MALARIA, A REVIEW
Raghuveer, C. V., & Goneppanavar, M. (2012) · Journal of Evolution of Medical and Dental Sciences · doi:10.14260/jemds/72 · Cited by 2 · see citing works
Malaria in the Pregnant Women
Silesky-Jiménez, J. I., & Hidalgo, J. (2021) · Springer eBooks · doi:10.1007/978-3-030-70034-8_31 · Cited by 2 · see citing works
PfLDH Detected in Etawa Crossbred Goats Using Polymerase Chain Reaction Methods
Sumanto, D., Sayono, S., Martini, M., Handoyo, W., & Kristini, T. D. (2021) · International Journal of Medical Parasitology and Epidemiology Sciences · doi:10.34172/ijmpes.2021.18 · Cited by 2 · see citing works
“The process of pLDH formation in the human host continues until the beginning of gametocyte stage and its presence can still be detectable several days after treatment (9) or, put it another way, as long as there are living parasites in the blood.”
Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH Based Rapid Diagnostic Tests among Children Under Five Years of Age in a High Seasonal Malaria Transmission Area in Burkina Faso
Ouédraogo, D. F., Natama, H. M., Sorgho, H., Kabore, S., Somé, M. A., Millogo, A., Ouédraogo, A.-R., Guetens, P., Kattenberg, J. H., Savadogo, A., et al. (2025) · Acta Parasitologica · doi:10.1007/s11686-025-01070-7 · Cited by 1 · see citing works
“Therefore, the proportion of malaria cases as detected by Pf HRP2-based RDTs could be overestimated, due to false positive test results when using these RDTs in non-malarial fever cases, including fever cases occurring after successful malaria treatment [8 – 11].”
False-positive Malaria Rapid Diagnostic Tests are Prevalent Among Children Under 5 Years of Age in Uganda
Cassidy, C. A., Shook‐Sa, B. E., Boyce, R. M., Ciccone, E. J., Gower, E. W., Young, A., & Edwards, J. K. (2025) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaf604 · Cited by 1 · see citing works
“Children tend to remain mRDT-positive longer than adults [8], and higher parasitemia at time of initial testing is associated with longer antigen persistence [9, 10].”
Quantification of Histidine-Rich Protein 3 of Plasmodium falciparum
Palani, B. (2018) · Monoclonal Antibodies in Immunodiagnosis and Immunotherapy · doi:10.1089/mab.2017.0068 · Cited by 1 · see citing works
“13–15) Sullivan et al. (16) have demonstrated heme polymerization in the presence of both HRP2 and HRP3.”
REFRACTORY ANEMIA AND PANCYTOPENIA AS PRESENTATIONS OF FALCIPARUM MALARIA IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN
Hayat, Z., Ullah, I., Hayat, K., Khan, H. A., Raziq, F., & Khan, H. (2020) · Gomal Journal of Medical Sciences · doi:10.46903/gjms/17.03.2027 · Cited by 1 · see citing works
Long-term evolution of Plasmodium falciparum gametocytes index during a village scale malaria vector control program comparing durable lining, long-lasting treated net and indoor residual spraying in Angola
Carnevale, P., Carnevale, N., Toto, J.-C., Foumane, V. N., Martineaud, F., & Manguin, S. (2022) · MOJ Public Health · doi:10.15406/mojph.2022.11.00369 · Cited by 1 · see citing works
The detection of two plasmodium falciparum metabolic enzymes using chicken antibodies.
Krause, R. (2012) · ResearchSpace (University of KwaZulu-Natal) · Cited by 1 · see citing works
A case of Plasmodium falciparum malaria: the importance of an integrated diagnostics
Notaris, P., Montevecchi, L., & Delprete, E. (2011) · Microbiologia medica · doi:10.4081/mm.2011.2380
Plasmodium falciparum malaria: assessing accuracy and cost-effectiveness in the villages of Dielmo and Ndiop, Senegal
Ly, A. B., Tall, A., Perry, R. T., Baril, L., Badiane, A., Faye, J., Rogier, C., Touré, A., Sokhna, C., Trape, J., et al. (2010)
NEW DIAGNOSTIC TOOLS FOR MALARIA- CHALLENGES AND OPPORTUNITIES
Schmidt, B. A. (2014) · Figshare
Investigations of filarial nematode motility, response to drug treatment, and pathology
Nutting, C. S. (2015) · ScholarWorks - WMU (Western Michigan University)
Editorial How Do We Best Diagnose Malaria in Africa?
Rosenthal, P. J. (2013)

and Results in False-Positive Diagnoses of Malaria Is Associated with Gametocytemia Plasmodium falciparum Treatment of and HRP2 Antigen Reactivity after Persistent ICT Malaria P.f/P.v Panmalarial
Anstey, N. M., Tjitra, E., Suprianto, S., McBroom, J., & Bart, J.-M. (2013)
Self-citation
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.
Tjitra, E., Suprianto, S., Dyer, M. E., Currie, B. J., & Anstey, N. M. (2001) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2001.65.593 · Cited by 31 · see citing works
Self-citation
Persistence of P. falciparum HRP-2 antigenaemia post treatment is not associated with gametocytesPreprint
Oulton, T., Mahamar, A., Sanogo, K., Diallo, M., Youssouf, A., Niambele, S. M., Samaké, S., Keita, S., Sinaba, Y., Sacko, A., et al. (2022) · Research Square · doi:10.21203/rs.3.rs-1920905/v1
Persistence of Plasmodium falciparum HRP-2 antigenaemia after artemisinin combination therapy is not associated with gametocytes
Oulton, T., Mahamar, A., Sanogo, K., Diallo, M., Youssouf, A., Niambele, S. M., Samaké, S., Keita, S., Sinaba, Y., Sacko, A., et al. (2022) · Malaria Journal · doi:10.1186/s12936-022-04387-0 · Cited by 11 · see citing works
The Panmalarial Antigen Detected by the ICT Malaria P.f./P.v. Immunochromatographic Test Is Expressed by Plasmodium malariae
Mason, D. P., Wongsrichanalai, C., Lin, K., Miller, R. S., & Kawamoto, F. (2001) · Journal of Clinical Microbiology · doi:10.1128/jcm.39.5.2035.2001 · Cited by 10 · see citing works

Authors: Tjitra, E., Suprianto, S., McBroom, J., Currie, B. J., & Anstey, N. M.
Affiliations: Menzies School of Health Research (AU)
Directorate General of Communicable Disease Control and Environmental Health,3 Jakarta, Indonesia, and
ORCID: Currie, Bart J.
Anstey, Nicholas M.
Venue: Journal of Clinical Microbiology
Publisher: American Society for Microbiology
Published: 2001-03
Volume: 39
Issue: 3
Pages: 1025-1031
ISSN: 0095-1137 (ISSN-L)
1098-660X
DOI: 10.1128/jcm.39.3.1025-1031.2001
PMC: PMC87868
OpenAlex: W1997483009
Cited by: 113
References: 22
Citations by year: 2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 1 · 2019: 6 · 2018: 5 · 2017: 6 · 2015: 5 · 2014: 5 · 2013: 11 · 2012: 9
FWCI: 3.49
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Journal of Clinical Microbiology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
CDU eSpace Institutional Repository (Charles Darwin University) (submittedVersion)
Griffith Research Online (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: falciparum malaria, Plasmodium vivax, HRP2 antigen, false-positive diagnosis, gametocytaemia, rapid diagnostic tests, sulfadoxine-pyrimethamine, chloroquine, convalescence
MeSH terms: Adult, Animals, Antigens, Protozoan, Antimalarials, Child, Child, Preschool, Convalescence, False Positive Reactions, Humans, Immunologic Tests, Microscopy, Plasmodium falciparum, Plasmodium vivax, Malaria, Falciparum, Malaria, Vivax

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Persistent ICT Malaria P.f/P.v Panmalarial and HRP2 Antigen Reactivity after Treatment of Plasmodium falciparum Malaria Is Associated with Gametocytemia and Results in False-Positive Diagnoses of Plasmodium vivax in Convalescence

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