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Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo

Received: 26 May 2021    Accepted: 11 June 2021    Published: 21 June 2021
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Abstract

Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly.

Published in Central African Journal of Public Health (Volume 7, Issue 4)
DOI 10.11648/j.cajph.20210704.12
Page(s) 159-163
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Malaria, Performance, Rapid Diagnostic Test, HRP2-based Test, Kinsantu Health Zone

References
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Cite This Article
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    Gillon Ilombe, Sylvie Linsuke, Aimé Lulebo, Joris Likwela, Paulin Mutombo, et al. (2021). Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Central African Journal of Public Health, 7(4), 159-163. https://doi.org/10.11648/j.cajph.20210704.12

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    ACS Style

    Gillon Ilombe; Sylvie Linsuke; Aimé Lulebo; Joris Likwela; Paulin Mutombo, et al. Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Cent. Afr. J. Public Health 2021, 7(4), 159-163. doi: 10.11648/j.cajph.20210704.12

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    AMA Style

    Gillon Ilombe, Sylvie Linsuke, Aimé Lulebo, Joris Likwela, Paulin Mutombo, et al. Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo. Cent Afr J Public Health. 2021;7(4):159-163. doi: 10.11648/j.cajph.20210704.12

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  • @article{10.11648/j.cajph.20210704.12,
      author = {Gillon Ilombe and Sylvie Linsuke and Aimé Lulebo and Joris Likwela and Paulin Mutombo and Pascal Lutumba and Jean-Pierre Van Geertruyden Rika Matangila and Junior Rika Matangila},
      title = {Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo},
      journal = {Central African Journal of Public Health},
      volume = {7},
      number = {4},
      pages = {159-163},
      doi = {10.11648/j.cajph.20210704.12},
      url = {https://doi.org/10.11648/j.cajph.20210704.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20210704.12},
      abstract = {Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Performance of Malaria Rapid Diagnostic Test in Asymptomatic Malaria Cases in Stable Transmission Area in Kisantu, Democratic Republic of Congo
    AU  - Gillon Ilombe
    AU  - Sylvie Linsuke
    AU  - Aimé Lulebo
    AU  - Joris Likwela
    AU  - Paulin Mutombo
    AU  - Pascal Lutumba
    AU  - Jean-Pierre Van Geertruyden Rika Matangila
    AU  - Junior Rika Matangila
    Y1  - 2021/06/21
    PY  - 2021
    N1  - https://doi.org/10.11648/j.cajph.20210704.12
    DO  - 10.11648/j.cajph.20210704.12
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 159
    EP  - 163
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20210704.12
    AB  - Background: Democratic Republic of Congo has shifted from pan test to mono-specific malaria RDT tests. A new Histidine rich protein 2 (HRP2)-based Rapid Diagnostic Tests for malaria diagnosis was then implemented. Objective: This study evaluated the performances of this new diagnostic tool compared to the thick smear as the gold standard. Method: The study was conducted in Kisantu Health zone in the Democratic Republic of the Congo (DRC) where malaria is known as endemic disease. Asymptomatic children aged between 0 and 10 years were included in the study. Malaria tests such as Rapid Diagnostic test (RDT) and blood smear were perform in all enrolled children. Blood smear was considered as a reference test. In the performance analysis, only thick positive smears confirmed as Pf by thin smear were considered positive in calculation. The sensitivity, specificity and positive and negative predictive values of CareStart Malaria Pf (HRP-2) RTD Ag compared to the thick smear. Result: The prevalence of malaria infection was 78.3% and 14.7% using rapid diagnostic test and thick blood smear, respectively. Considering the gold standard, proportion of false positives was 77.5%. The Sensitivity was 83.1% (CI95%: 72.4-94.9) and specificity was 22.5% (CI95%: 20.2-25.0). The Positive Predictive Value (PPV) was 15.2% and Negative Predictive Value (NPV) was 88.9%. It appears that the HRP2-based test presently used in the Democratic Republic of Congo over estimates malaria infections. Conclusion: CareStart Malaria Pf (HRP-2) RTD Ag, currently in use in the DRC detects a very high proportion of false positives. Those children falsely positive were subject to be treated unnecessarily. Therefore, there is need of adapting the choice of RDT for malaria policy accordingly.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Parasitology, Unit of Entomology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of Congo

  • Global Health Institute, University of Antwerp, Antwerp, Belgium

  • Faculty of Medicine, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo

  • School of Public Health, Faculty of Medicine, University of Kisangani, Kisangani, Democratic Republic of Congo

  • Faculty of Medicine, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo

  • Department of Tropical Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo

  • Global Health Institute, University of Antwerp, Antwerp, Belgium

  • Department of Tropical Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo

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