Performance of a Histidine-Rich Protein 2 Rapid Diagnostic Test, Paracheck Pf®, for Detection of Malaria Infections in Ugandan Pregnant Women
Open accessAbstract
Improved laboratory diagnosis is critical to reduce the burden of malaria in pregnancy. Peripheral blood smears appear less sensitive than Plasmodium falciparum histidine-rich protein 2–based rapid diagnostic tests (RDTs) for placental malaria infections in studies conducted at delivery. In this study, 81 women in Uganda in the second or third trimester of pregnancy were followed-up until delivery. At each visit, peripheral blood was tested by blood smear, RDT, and nested species-specific polymerase chain reaction (PCR). Sensitivity and specificity of the tests was calculated with PCR, which detected 22 infections of P. falciparum, as the gold standard. The sensitivity and specificity of blood smears were 36.4% (95% confidence interval [CI] = 18.0–59.2%) and 99.6% (95% CI = 97.7–100%), respectively. The corresponding values for RDT were 31.8% (95% CI = 14.7–54.9%) and 100% (95% CI = 98.3–100%). The RDTs could replace blood smears for diagnosis of malaria in pregnancy by virtue of their relative ease of use. Field-based sensitive tests for malaria in pregnancy are urgently needed.
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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 [17]
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 [17]
RDT kits used during pregnancy in Uganda had low sensitivity (31.8%) but full specificity (100%) when PCR was used as the gold standard.
“Recently low sensitivity (31.8%) but full specificity (100%) was reported for RDT kits used during pregnancy in Uganda, where PCR was used as the gold standard [13].”
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 [13]
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 [13]
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- Authors
- Dhorda, M., Piola, P., Nyehangane, D., Tumwebaze, B., Nalusaji, A., Nabasumba, C., Turyakira, E., McGready, R., Ashley, E., Guerin, P. J., & Snounou, G.
- Affiliations
- Epicentre Uganda (UG)
- Corresponding author
- Dhorda, Mehul
- ORCID
- Venue
- The American Society of Tropical Medicine and Hygiene
- Published
- 2012-01-01
- Volume
- 86
- Issue
- 1
- Pages
- 93-95
- ISSN
- 0002-9637 (ISSN-L)
- 1476-1645
- PMC
- PMC3247114
- OpenAlex
- W2142444201
- Cited by
- 23
- References
- 18
- Citations by year
- 2026: 1 · 2022: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 6
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Tropical Medicine and Hygiene (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Medecins Sans Frontieres Field Research (Medecins Sans Frontieres) (submittedVersion)
- Funders
- University of Oxford
- European Commission
- Institut National de la Santé et de la Recherche Médicale
- Université Pierre et Marie Curie
- 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 falciparum, HRP-2, rapid diagnostic tests, peripheral blood smear, sensitivity and specificity, nested PCR, placental malaria
- MeSH terms
- Artemether, Lumefantrine Drug Combination, Antigens, Protozoan, Antimalarials, Diagnostic Tests, Routine, Drug Combinations, Ethanolamines, Female, Fluorenes, Humans, Plasmodium falciparum, Pregnancy, Quinine, Sensitivity and Specificity, Species Specificity, Uganda, Pregnancy Complications, Parasitic, Protozoan Proteins, Polymerase Chain Reaction, Malaria, Falciparum, Treatment Outcome, Artemisinins
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