Abstract
In this study, we evaluated the performance of a P. falciparum Histidine Rich Protein 2 (PfHRP2)-based rapid diagnostic test (RDT) used for malaria case detection (SD-Bioline malaria RDT P.f®) along with light microscopy (LM) against qPCR among children during the first year of life in a high and seasonal malaria transmission area in Burkina Faso. A total of 723 suspected malaria cases (including multiple episodes) that occurred among 414 children participating in a birth-cohort study were included in the present analysis. Factors including age at the time of malaria screening, transmission season and parasite densities were investigated for their potential influence in the performance of the RDT. Clinical malaria cases as detected by RDT, LM and qPCR were 63.8%, 41.5% and 49.8%, respectively. Compared with qPCR, RDT had a false-positive results rate of 26.7%, resulting in an overall accuracy of 79.9% with a sensitivity of 93%, a specificity of 66.1%, a Positive Predictive Value of 73.3% and a Negative Predictive Value of 91.6%. Its specificity differed significantly between high and low transmission seasons (53.7% vs 79.8%; P < 0.001) and decreased with increasing age (80.6–62%; P for trend = 0.024). The overall accuracy of LM was 91.1% and its performance was not significantly influenced by transmission season or age. These findings highlight the need to adapt malaria diagnostic tools recommendations to face the challenge of adequate malaria detection in this population group living in high burden and seasonal malaria transmission settings.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Change history
22 February 2023
A Correction to this paper has been published: https://doi.org/10.1007/s12639-023-01570-1
References
Afolabi BM, Salako LA, Mafe AG et al (2001) Malaria in the first 6 months of life in urban African infants with anemia. Am J Trop Med Hyg 65:822–827
Amir A, Cheong FW, De Silva JR, Lau YL (2018) Diagnostic tools in childhood malaria. Parasit Vectors 11:53. https://doi.org/10.1186/s13071-018-2617-y
Balikagala B, Fukuda N, Ikeda M et al (2021) Evidence of artemisinin-resistant Malaria in Africa. New England J Med. https://doi.org/10.1056/nejmoa2101746
Baltzell K, Kortz TB, Scarr E et al (2019) ’Not all fevers are malaria’: a mixed methods study of non-malarial fever management in rural Southern Malawi. Rural Remote Health 19:4818. https://doi.org/10.22605/RRH4818
Branch OH, Udhayakumar V, Hightower AW et al (1998) A longitudinal investigation of IgG and IgM antibody responses to the merozoite surface protein-1 19-kiloDalton domain of Plasmodium falciparum in pregnant women and infants: associations with febrile illness, parasitemia, and anemia. Am J Trop Med Hyg 58:211–219. https://doi.org/10.4269/ajtmh.1998.58.211
Burkina Faso: Ministère de la Santé (2018) Annuaire statistique 2017. Available at http://cns.bf/IMG/pdf/annuaire_ms_2017.pdf
Burkina Faso: Ministère de la santé (2021) Annuaire statistique 2020. Available at https://www.sante.gov.bf/fileadmin/user_upload/storages/annuaire_statistique_ms_2020_signe.pdf
Cairns M, Ceesay SJ, Sagara I et al (2021) Effectiveness of seasonal malaria chemoprevention (SMC) treatments when SMC is implemented at scale: case–control studies in 5 countries. PLoS Medi 18:e1003727. https://doi.org/10.1371/journal.pmed.1003727
Ceesay SJ, Koivogui L, Nahum A et al (2015) Malaria prevalence among young infants in different transmission settings, Africa. Emerg Infect Dis 21:1114–1121. https://doi.org/10.3201/eid2107.142036
Gatton ML, Chaudhry A, Glenn J et al (2020) Impact of Plasmodium falciparum gene deletions on malaria rapid diagnostic test performance. Malar J 19:392. https://doi.org/10.1186/s12936-020-03460-w
Hofmann N, Mwingira F, Shekalaghe S et al (2015) Ultra-sensitive detection of plasmodium falciparum by amplification of multi-copy subtelomeric targets. PLoS Med 12:e1001788. https://doi.org/10.1371/journal.pmed.1001788
Hogh B, Marbiah NT, Burghaus PA, Andersen PK (1995) Relationship between maternally derived anti-Plasmodium falciparum antibodies and risk of infection and disease in infants living in an area of Liberia, West Africa, in which malaria is highly endemic. Infect Immun 63:4034–4038. https://doi.org/10.1128/iai.63.10.4034-4038.1995
Khattab A, Chia Y, May J et al (2007) The impact of IgG antibodies to recombinant Plasmodium falciparum 732var CIDR-1alpha domain in mothers and their newborn babies. Parasitol Res 101:767–774. https://doi.org/10.1007/s00436-007-0548-1
Kitua AY, Smith T, Alonso PL et al (1996) Plasmodium falciparum malaria in the first year of life in an area of intense and perennial transmission. Tropical Med Int Health 1:475–484. https://doi.org/10.1046/j.1365-3156.1996.d01-89.x
Kyabayinze DJ, Tibenderana JK, Odong GW et al (2008) Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J 7:221. https://doi.org/10.1186/1475-2875-7-221
Laurent A, Schellenberg J, Shirima K et al (2010) Performance of HRP-2 based rapid diagnostic test for malaria and its variation with age in an area of intense malaria transmission in southern tanzania. Malar J 9:294. https://doi.org/10.1186/1475-2875-9-294
Martiáñez-Vendrell X, Skjefte M, Sikka R, Gupta H (2022) Factors affecting the performance of HRP2-based malaria rapid diagnostic tests. Trop Med Infect Dis 7:265. https://doi.org/10.3390/tropicalmed7100265
Molina-de la Fuente I, Pastor A, Herrador Z et al (2021) Impact of Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions on malaria control worldwide: a systematic review and meta-analysis. Malar J 20:276. https://doi.org/10.1186/s12936-021-03812-0
Moody A (2002) Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 15:66–78. https://doi.org/10.1128/CMR.15.1.66-78.2002
Natama HM, Vallbona ER, Somé MA et al (2018) Malaria incidence and prevalence during the first year of life in Nanoro, Burkina Faso: a birth-cohort study. Malar J 17:163. https://doi.org/10.1186/s12936-018-2315-4
Pati P, Dhangadamajhi G, Bal M, Ranjit M (2018) High proportions of pfhrp2 gene deletion and performance of HRP2-based rapid diagnostic test in Plasmodium falciparum field isolates of Odisha. Malar J 17:394. https://doi.org/10.1186/s12936-018-2502-3
Plucinski MM, Dimbu PR, Fortes F et al (2018) Posttreatment HRP2 clearance in patients with uncomplicated plasmodium falciparum malaria. J Infect Dis 217:685–692. https://doi.org/10.1093/infdis/jix622
R Core Team (2016) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria.
Reichert EN, Hume JCC, Sagara I et al (2020) Ultra-sensitive RDT performance and antigen dynamics in a high-transmission Plasmodium falciparum setting in Mali. Malar J 19:323. https://doi.org/10.1186/s12936-020-03389-0
Tinto H, Sombié O, Valea I et al (2015) Field evaluation of SD Bioline Malaria Antigen P.f® for Plasmodium falciparum malaria diagnosis in Nanoro, Burkina Faso. African J Parasitol Res 4:161–165
Tiono AB, Diarra A, Sanon S et al (2013) Low specificity of a malaria rapid diagnostic test during an integrated community case management trial. Infectious Dis Therapy. https://doi.org/10.1007/s40121-013-0006-6
Uwimana A, Legrand E, Stokes BH et al (2020) Emergence and clonal expansion of in vitro artemisinin-resistant Plasmodium falciparum kelch13 R561H mutant parasites in Rwanda. Nat Med. https://doi.org/10.1038/s41591-020-1005-2
Wainaina M, Vey da Silva DA, Dohoo I et al (2022) A systematic review and meta-analysis of the aetiological agents of non-malarial febrile illnesses in Africa. PLoS Neglected Tropical Dis 16:e0010144. https://doi.org/10.1371/JOURNAL.PNTD.0010144
WHO (2010) Basic Malaria Microscopy: Part I. Learner’s Guide. 2nd ed. World Hearlth Organization. Available at https://www.who.int/publications/i/item/9241547820
WHO (2012) WHO policy recommendation: seasonal malaria chemoprevention (SMC) for Plasmodium falciparum malaria control in highly seasonal transmission areas of the Sahel sub-region in Africa. Available at https://apps.who.int/iris/bitstream/handle/10665/337978/WHO-HTM-GMP-2012.02-eng.pdf?sequence=1&isAllowed=y
WHO (2015) Guidelines for the treatment of malaria. Third edition. World Health Organization. Available at https://doi.org/10.1016/0035-9203(91)90261-V
WHO (2018) Malaria rapid diagnostic test performance: results of WHO product testing of malaria RDTs: round 8 (2016–2018). Available at https://www.who.int/publications/i/item/9789241514965
WHO (2021) World malaria report 2021. Available at https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2021
Funding
This study was supported by the Belgium Directorate General for Development Cooperation (DGD) through the collaborative framework agreement 3 (FA3–DGD programme) between CRUN (Burkina Faso) and ITM (Belgium) and by European community’s Seventh Framework Programme under grant agreement No. 305662 (Project: Community-based scheduled screening and treatment of malaria in pregnancy for improved maternal and infant health: a cluster-randomized trial ‘COSMIC’).
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HMN, TET, TR, MAS, ERV and ARU conceived and designed the study. All authors contributed to data and samples collection in the field. HMN, MAS and SHZ supervised malaria diagnosis and management of malaria patients in peripheral health centers. HMN, PG and ERV performed the qPCR experiments. The first draft of the manuscript was written by HMN, TET, TR, MAS, ERV and ARU and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Written informed consent was obtained from the parents.
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This study was performed in line with the principles of the Declaration of Helsinki. Approvals were granted by institutional ethics committees at Centre Muraz, Bobo Dioulasso, Burkina Faso (006-2014/CE-CM), Institute of Tropical Medicine, Antwerp, Belgium (953/14) and University Hospital in Antwerp (UZA), Belgium (14/26/277).
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Natama, H.M., Traoré, T.E., Rouamba, T. et al. Performance of PfHRP2-RDT for malaria diagnosis during the first year of life in a high malaria transmission area in Burkina Faso. J Parasit Dis 47, 280–289 (2023). https://doi.org/10.1007/s12639-023-01566-x
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DOI: https://doi.org/10.1007/s12639-023-01566-x