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Field evaluation of a rapid diagnostic test (Parascreen) for malaria diagnosis in the Peruvian Amazon.
- Source :
-
Malaria journal [Malar J] 2010 Jun 07; Vol. 9, pp. 154. Date of Electronic Publication: 2010 Jun 07. - Publication Year :
- 2010
-
Abstract
- Background: The rapid diagnostic tests for malaria (RDT) constitute a fast and opportune alternative for non-complicated malaria diagnosis in areas where microscopy is not available. The objective of this study was to validate a RDT named Parascreen under field conditions in Iquitos, department of Loreto, Peru. Parascreen is a RDT that detects the histidine-rich protein 2 (HRP2) antigen from Plasmodium falciparum and lactate deshydrogenase from all Plasmodium species.<br />Methods: Parascreen was compared with microscopy performed by experts (EM) and polymerase chain reaction (PCR) using the following indicators: sensitivity (Se), specificity (Sp), positive (PV+) and negative predictive values (PV-), positive (LR+) and negative likehood ratio (LR-).<br />Results: 332 patients with suspected non-complicated malaria who attended to the MOH health centres were enrolled between October and December 2006. For P. falciparum malaria, Parascreen in comparison with EM, had Se: 53.5%, Sp: 98.7%, PV+: 66.7%, PV-: 97.8%, LR+: 42.27 and LR-: 0.47; and for non-P. falciparum malaria, Se: 77.1%, Sp: 97.6%, PV+: 91.4%, PV-: 92.7%, LR+: 32.0 and LR-: 0.22. The comparison of Parascreen with PCR showed, for P. falciparum malaria, Se: 81.8%, Sp: 99.1%, PV+: 75%, PV-: 99.4, LR+: 87.27 and LR-: 0.18; and for non-P. falciparum malaria Se: 76.1%, Sp: 99.2%, PV+: 97.1%, PV-: 92.0%, LR+: 92.51 and LR-: 0.24.<br />Conclusions: The study results indicate that Parascreen is not a valid and acceptable test for malaria diagnosis under the field conditions found in the Peruvian Amazon. The relative proportion of Plasmodium species, in addition to the genetic characteristics of the parasites in the area, must be considered before applying any RDT, especially after the finding of P. falciparum malaria parasites lacking pfhrp2 gene in this region.
- Subjects :
- Adolescent
Adult
Antigens, Protozoan genetics
Antigens, Protozoan immunology
False Positive Reactions
Female
Humans
Immunoassay methods
L-Lactate Dehydrogenase blood
L-Lactate Dehydrogenase immunology
Male
Microscopy
Middle Aged
Peru
Plasmodium falciparum genetics
Plasmodium falciparum immunology
Plasmodium vivax genetics
Plasmodium vivax immunology
Polymerase Chain Reaction
Protozoan Proteins blood
Protozoan Proteins genetics
Protozoan Proteins immunology
Reagent Kits, Diagnostic
Reproducibility of Results
Sensitivity and Specificity
Young Adult
Antigens, Protozoan blood
Immunoassay standards
Malaria, Falciparum diagnosis
Malaria, Vivax diagnosis
Plasmodium falciparum isolation & purification
Plasmodium vivax isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2875
- Volume :
- 9
- Database :
- MEDLINE
- Journal :
- Malaria journal
- Publication Type :
- Academic Journal
- Accession number :
- 20529273
- Full Text :
- https://doi.org/10.1186/1475-2875-9-154