Conventional and High-Sensitivity Malaria Rapid Diagnostic Test Performance in 2 Transmission Settings: Haiti 2017. (21st October 2019)

• Record Type: Journal Article
• Authors: Rogier, Eric; Hamre, Karen E S; Joseph, Vena; Plucinski, Mateusz M; Presume, Jacquelin; Romilus, Ithamare; Mondelus, Gina; Elisme, Tamara; van den Hoogen, Lotus; Lemoine, Jean Frantz; Drakeley, Chris; Ashton, Ruth A; Chang, Michelle A; Existe, Alexandre; Boncy, Jacques; Stresman, Gillian; Druetz, Thomas; Eisele, Thomas P
• Is Part Of: Journal of infectious diseases. Volume 221:Number 5(2020)
• Page Start: 786
• Page End: 795
• Publication Date: 2019-10-21
• Subjects: Plasmodium falciparum -- rapid diagnostic test -- HRP2 -- malaria elimination -- Haiti; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiz525
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Accurate malaria diagnosis is foundational for control and elimination, and Haiti relies on histidine-rich protein 2 (HRP2)–based rapid diagnostic tests (RDTs) identifying Plasmodium falciparum in clinical and community settings. In 2017, 1 household and 2 easy-access group surveys tested all participants (N = 32 506) by conventional and high-sensitivity RDTs. A subset of blood samples (n = 1154) was laboratory tested for HRP2 by bead-based immunoassay and for P. falciparum 18S rDNA by photo-induced electron transfer polymerase chain reaction. Both RDT types detected low concentrations of HRP2 with sensitivity estimates between 2.6 ng/mL and 14.6 ng/mL. Compared to the predicate HRP2 laboratory assay, RDT sensitivity ranged from 86.3% to 96.0% between tests and settings, and specificity from 90.0% to 99.6%. In the household survey, the high-sensitivity RDT provided a significantly higher number of positive tests, but this represented a very small proportion (<0.2%) of all participants. These data show that a high-sensitivity RDT may have limited utility in a malaria elimination setting like Haiti.