EVALUATION OF A MALARIA RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA DURING PREGNANCY

SINGER, LAUREN M.; NEWMAN, ROBERT D.; DIARRA, AMIDOU; MORAN, ALLISYN C.; HUBER, CURTIS S.; STENNIES, GAIL; SIRIMA, SODIOMON B.; KONATE, AMADOU; YAMEOGO, MATHIAS; SAWADOGO, ROMIAL; BARNWELL, JOHN W.; PARISE, MONICA E.

doi:10.4269/ajtmh.2004.70.481

Cited by 77Malaria Research and ControlBiosensors and Analytical DetectionHemoglobinopathies and Related Disorders

EVALUATION OF A MALARIA RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA DURING PREGNANCY

SINGER, LAUREN M., NEWMAN, ROBERT D., DIARRA, AMIDOU, MORAN, ALLISYN C., HUBER, CURTIS S., STENNIES, GAIL, SIRIMA, SODIOMON B., KONATE, AMADOU +4 more·2004·The American Journal of Tropical Medicine and Hygiene

DOI 10.4269/ajtmh.2004.70.481

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Abstract

Plasmodium falciparum infection during pregnancy may cause placental malaria and subsequently low birth weight, primarily through the placental sequestration of infected red blood cells. Measuring the burden of malaria during pregnancy usually involves determining the prevalence of placental malaria infection through microscopic examination of placental blood films, a difficult and error-prone process. A number of rapid diagnostic tests (RDTs) for malaria have been developed, most of them immunochromatographic dipstick assays. However, none have been tested for the direct determination of malaria antigen in placental blood. We undertook an evaluation of the Malaria Rapid Test (MAKROmed®) in determining placental malaria infection. The prevalence of placental parasitemia was 22.6% by microscopy, 51.0% by a polymerase chain reaction (PCR), and 43.1% by RDT. When the PCR was used as the gold standard, RDTs had a sensitivity of 89% and a specificity of 76%. The MAKROmed RDT was highly sensitive in the detection of placental malaria, but had lower than expected specificity.

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When performed on peripheral blood for pregnancy malaria diagnosis, RDT-HRP2 sensitivity is more than 90% compared with peripheral blood smear and 80-95% compared with placental blood smear, with specificity between 61 and 94%.
“When performed on peripheral blood samples for PM diagnoses, RDT-HRP2 sensitivity was more than 90% when compared with peripheral BS, and 80–95% when compared with placental BS, with specificity between 61 and 94% [13–16].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
The sensitivity of RDT-HRP2 using peripheral blood is much lower when compared with PCR detection of parasite nucleic acids in peripheral or placental blood.
“The sensitivity of RDT-HRP2 using peripheral blood samples was much lower when compared with PCR detection of parasite nucleic acids in peripheral or placental blood (Table 1)[15–17].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Compared to PCR performed on placental or peripheral blood, the sensitivity of RDT tests was low in two of three pregnancy malaria diagnostics studies.
“Compared to PCR performed on placental or peripheral blood [14,15,17], the sensitivity of RDT tests was low in two of three PM diagnostics studies.”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Whether applied to peripheral blood or placental blood samples, PCR methods yield positivity rates 20% or more above those of blood smear microscopy.
“Whether applied to peripheral blood or placental blood samples, PCR methods yield positivity rates 20% or more above those of BS microscopy (Tables 3 & 4) [10,14–16,38–46].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Submicroscopic placental infection was associated with reduced birthweight in several studies.
“Submicroscopic placental infection was associated with reduced birthweight in several studies [15,44,45].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]

In one study, reduced birthweight was associated with parasites detected by microscopy, RDT-HRP2 or PCR in placental blood, but not with parasites detected in peripheral blood.
“In one study, reduced birthweight was associated with parasites detected by microscopy, RDT-HRP2 or PCR in placental blood, but not parasites detected in peripheral blood [15].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
HRP2 or pLDH detected in placental blood has been associated with increased rates of low birthweight in some studies but not in Mozambique.
“HRP2 or pLDH detected in placental blood has been associated with increased rates of LBW in some studies [10,15,53] but not in Mozambique [16].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Positive placental blood PCR was associated with an increased rate of low birthweight in one study but not in several others.
“Positive placental blood PCR was associated with an increased rate of LBW in one study [15] but not several others [10,16,53].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Previous studies conducted at the time of birth have shown that RDT detecting P. falciparum HRP2 are more sensitive than blood smears, and appear to be reliable predictors of adverse outcomes of malaria in pregnancy.
“Previous studies conducted at the time of birth have shown that RDT detecting P. falciparum HRP2 are more sensitive than blood smears, and appear to be reliable predictors of adverse outcomes of malaria in pregnancy [30-32].”
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 [32]
Other studies did not observe an association between submicroscopic infection and increased low birthweight.
“However, other studies did not observe an association between submicroscopic infection and increased LBW [15,42].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [15]
Microscopy visualizes viable whole parasites in erythrocytes, while PCR detects parasite DNA.
“Microscopy visualizes viable whole parasites in erythrocytes, while PCR detects parasite DNA. 34”
From What is the burden of submicroscopic malaria in pregnancy in central India? (2015) · cites this paper as [34]

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EVALUATION OF A RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA AT DELIVERY IN INDIA
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Authors: SINGER, L. M., NEWMAN, R. D., DIARRA, A., MORAN, A. C., HUBER, C. S., STENNIES, G., SIRIMA, S. B., KONATE, A., YAMEOGO, M., SAWADOGO, R., BARNWELL, J. W., & PARISE, M. E.
Affiliations: Centers for Disease Control and Prevention (US)
Malaria Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre National de Recherche et de Formation sur le Paludisme, Ministére de la Santé, Ouagadougou, Burkina, Faso; Maternal and Neonatal Health Program, JHPIEGO Corporation, Baltimore, Maryland; Sante Maternelle et Neonatale, Koupéla, Burkina Faso
ORCID: NEWMAN, ROBERT D.
DIARRA, AMIDOU
MORAN, ALLISYN C.
SIRIMA, SODIOMON B.
Venue: The American Journal of Tropical Medicine and Hygiene
Publisher: American Society of Tropical Medicine and Hygiene
Published: 2004-05
Volume: 70
Issue: 5
Pages: 481-485
ISSN: 0002-9637 (ISSN-L)
DOI: 10.4269/ajtmh.2004.70.481
OpenAlex: W2171989251
Cited by: 77
References: 13
Citations by year: 2025: 1 · 2024: 1 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 2 · 2012: 10
FWCI: 6.73
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Tropical Medicine and Hygiene (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Physical Sciences › Engineering › Biomedical Engineering › Biosensors and Analytical Detection
Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Keywords: placental malaria, malaria in pregnancy, rapid diagnostic tests, Plasmodium falciparum, sensitivity and specificity, low birth weight, placental sequestration
MeSH terms: Birth Weight, Female, Humans, Infant, Newborn, Microscopy, Placenta Diseases, Pregnancy, Sensitivity and Specificity, Pregnancy Complications, Parasitic, Polymerase Chain Reaction, Malaria, Falciparum, Parasitemia

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EVALUATION OF A MALARIA RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA DURING PREGNANCY

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