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Comparison of HRP2- and pLDH-based rapid diagnostic tests for malaria with longitudinal follow-up in Kampala, Uganda.
Am J Trop Med Hyg. 2007 Jun; 76(6):1092-7.AJ

Abstract

Presumptive treatment of malaria results in significant overuse of antimalarials. Malaria rapid diagnostic tests (RDTs) may offer a reliable alternative for case management, but the optimal RDT strategy is uncertain. We compared the diagnostic accuracy of histidine-rich protein 2 (HRP2)- and plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as the gold standard, in a longitudinal study of 918 fever episodes over an 8-month period in a cohort of children in Kampala, Uganda. Sensitivity was 92% for HRP2 and 85% for pLDH, with differences primarily due to better detection with HRP2 at low parasite densities. Specificity was 93% for HRP2 and 100% for pLDH, with differences primarily due to rapid clearance of pLDH antigenemia after treatment of a previous malaria episode. RDTs may provide an effective strategy for improving rational delivery of antimalarial therapy; in Kampala, either test could dramatically decrease inappropriate presumptive treatments.

Authors+Show Affiliations

Hopkins H
University of California, San Francisco, San Francisco, California 94143, USA. hhopkins@medsfgh.ucsf.edu
Kambale W
No affiliation info available
Kamya MR
No affiliation info available
Staedke SG
No affiliation info available
Dorsey G
No affiliation info available
Rosenthal PJ
No affiliation info available

MeSH

AnimalsAntigens, ProtozoanChildChild, PreschoolCohort StudiesDNA, ProtozoanHumansInfantL-Lactate DehydrogenaseLongitudinal StudiesMalaria, FalciparumPlasmodium falciparumPolymerase Chain ReactionProtozoan ProteinsReagent Kits, DiagnosticSensitivity and SpecificityUganda

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17556616

Clinical Trial Links

Rapid Diagnostic Tests (RDTs) for Malaria in Kampala, Uganda

Citation

Hopkins, Heidi, et al. "Comparison of HRP2- and pLDH-based Rapid Diagnostic Tests for Malaria With Longitudinal Follow-up in Kampala, Uganda." The American Journal of Tropical Medicine and Hygiene, vol. 76, no. 6, 2007, pp. 1092-7.
Hopkins H, Kambale W, Kamya MR, et al. Comparison of HRP2- and pLDH-based rapid diagnostic tests for malaria with longitudinal follow-up in Kampala, Uganda. Am J Trop Med Hyg. 2007;76(6):1092-7.
Hopkins, H., Kambale, W., Kamya, M. R., Staedke, S. G., Dorsey, G., & Rosenthal, P. J. (2007). Comparison of HRP2- and pLDH-based rapid diagnostic tests for malaria with longitudinal follow-up in Kampala, Uganda. The American Journal of Tropical Medicine and Hygiene, 76(6), 1092-7.
Hopkins H, et al. Comparison of HRP2- and pLDH-based Rapid Diagnostic Tests for Malaria With Longitudinal Follow-up in Kampala, Uganda. Am J Trop Med Hyg. 2007;76(6):1092-7. PubMed PMID: 17556616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of HRP2- and pLDH-based rapid diagnostic tests for malaria with longitudinal follow-up in Kampala, Uganda. AU - Hopkins,Heidi, AU - Kambale,Wilson, AU - Kamya,Moses R, AU - Staedke,Sarah G, AU - Dorsey,Grant, AU - Rosenthal,Philip J, PY - 2007/6/9/pubmed PY - 2007/8/23/medline PY - 2007/6/9/entrez SP - 1092 EP - 7 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 76 IS - 6 N2 - Presumptive treatment of malaria results in significant overuse of antimalarials. Malaria rapid diagnostic tests (RDTs) may offer a reliable alternative for case management, but the optimal RDT strategy is uncertain. We compared the diagnostic accuracy of histidine-rich protein 2 (HRP2)- and plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as the gold standard, in a longitudinal study of 918 fever episodes over an 8-month period in a cohort of children in Kampala, Uganda. Sensitivity was 92% for HRP2 and 85% for pLDH, with differences primarily due to better detection with HRP2 at low parasite densities. Specificity was 93% for HRP2 and 100% for pLDH, with differences primarily due to rapid clearance of pLDH antigenemia after treatment of a previous malaria episode. RDTs may provide an effective strategy for improving rational delivery of antimalarial therapy; in Kampala, either test could dramatically decrease inappropriate presumptive treatments. SN - 0002-9637 UR - https://www.unboundmedicine.com/medline/citation/17556616/Comparison_of_HRP2__and_pLDH_based_rapid_diagnostic_tests_for_malaria_with_longitudinal_follow_up_in_Kampala_Uganda_ L2 - https://core.ac.uk/reader/13102854?utm_source=linkout DB - PRIME DP - Unbound Medicine ER -