Operational Performance of a Plasmodium falciparum Ultrasensitive Rapid Diagnostic Test for Detection of Asymptomatic Infections in Eastern Myanmar
| Autor: | Jordi Landier, Peter R. Christensen, Gilles Delmas, Jathee Raksuansak, Pase Phattharakokoedbun, François Nosten, Gonzalo J. Domingo, Kamonchanok Konghahong, Jacher Wiladphaingern, Smita Das, May Myo Thwin, Ladda Kajeechiwa, Stephane Proux, Warat Haohankhunnatham, Khin Maung Lwin, Ihn Kyung Jang, Clare Ling, Mallika Imwong |
|---|---|
| Přispěvatelé: | Dupuis, Christine, Shoklo Malaria Research Unit [Mae Sot, Thailand] (SMRU), Mahidol Oxford Tropical Medicine Research Unit (MORU), University of Oxford-Mahidol University [Bangkok]-Wellcome Trust-University of Oxford-Mahidol University [Bangkok]-Wellcome Trust, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Diagnostics Program [Seattle, WA, USA] (PATH), University of Oxford-Mahidol University [Bangkok]-Wellcome Trust, Centre for Tropical Medicine and Global Health [Oxford, UK], Nuffield Department of Medicine [Oxford, UK] (Big Data Institute), University of Oxford-University of Oxford, This work was supported by the Wellcome Trust (041843), the Bill and Melinda Gates Foundation (OPP1117507 and OPP1135840), the Regional Artemisinin Initiative (Global Fund against AIDS, Tuberculosis and Malaria). SMRU is part of the Mahidol Oxford University Research Unit, supported by the Wellcome Trust of Great Britain., Wellcome Trust-Mahidol University [Bangkok]-University of Oxford [Oxford]-Wellcome Trust-Mahidol University [Bangkok]-University of Oxford [Oxford], Wellcome Trust-Mahidol University [Bangkok]-University of Oxford [Oxford], University of Oxford [Oxford]-University of Oxford [Oxford] |
| Rok vydání: | 2018 |
| Předmět: |
Male
Protozoan Proteins Myanmar Parasitemia 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Prevalence Medicine Multiplex 030212 general & internal medicine Malaria Falciparum Asymptomatic Infections rapid tests Microscopy Rapid diagnostic test biology Middle Aged 3. Good health [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases Female medicine.symptom [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology Adult Microbiology (medical) Plasmodium falciparum 030231 tropical medicine malaria Antigens Protozoan Enzyme-Linked Immunosorbent Assay Real-Time Polymerase Chain Reaction Sensitivity and Specificity Asymptomatic 03 medical and health sciences parasitic diseases Humans [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology Mass screening asymptomatic infection Diagnostic Tests Routine business.industry ultrasensitive RDT low density parasitemia biology.organism_classification medicine.disease Virology [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Parasitology business low transmission setting Asymptomatic carrier Malaria |
| Zdroj: | Journal of Clinical Microbiology Journal of Clinical Microbiology, 2018, 56 (8), pp.565-583. ⟨10.1128/JCM.00565-18⟩ Journal of Clinical Microbiology, American Society for Microbiology, 2018, 56 (8), pp.565-583. ⟨10.1128/JCM.00565-18⟩ |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.00565-18 |
| Popis: | In the Greater Mekong Subregion in Southeast Asia, malaria elimination strategies need to target all Plasmodium falciparum parasites, including those carried asymptomatically. More than 70% of asymptomatic carriers are not detected by current rapid diagnostic tests (RDTs) or microscopy. In the Greater Mekong Subregion in Southeast Asia, malaria elimination strategies need to target all Plasmodium falciparum parasites, including those carried asymptomatically. More than 70% of asymptomatic carriers are not detected by current rapid diagnostic tests (RDTs) or microscopy. An HRP2-based ultrasensitive RDT (uRDT) developed to improve the detection of low-density infections was evaluated during prevalence surveys within a malaria elimination program in a low-transmission area of eastern Myanmar. Surveys were conducted to identify high-prevalence villages. Two-milliliter venous blood samples were collected from asymptomatic adult volunteers and transported to the laboratory. Plasmodium parasites were detected by RDT, uRDT, microscopy, ultrasensitive qPCR (uPCR), and multiplex enzyme-linked immunosorbent assay (ELISA). The sensitivity, specificity, and predictive positive and negative values of RDT and uRDT were calculated compared to uPCR and ELISA. Parasite and antigen concentrations detected by each test were defined using uPCR and ELISA, respectively. A total of 1,509 samples, including 208 P. falciparum-positive samples were analyzed with all tests. The sensitivity of the uRDT was twofold higher than that of RDT, 51.4% versus 25.2%, with minor specificity loss, 99.5% versus 99.9%, against the combined reference (uPCR plus ELISA). The geometric mean parasitemia detected by uRDT in P. falciparum monospecific infections was 3,019 parasites per ml (95% confidence interval [95% CI], 1,790 to 5,094; n = 79) compared to 11,352 parasites per ml (95% CI, 5,643 to 22,837; n = 38) by RDT. The sensitivities of uRDT and RDT dropped to 34.6% and 15.1%, respectively, for the matched tests performed in the field. The uRDT performed consistently better than RDT and microscopy at low parasitemias. It shows promising characteristics for the identification of high-prevalence communities and warrants further evaluation in mass screening and treatment interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|