Field evaluation of a malaria rapid diagnostic test (ICT Pf)

BACKGROUND: Malaria rapid diagnostic tests (MRDTs) are quick and easy to perform and useful for diagnosing malaria in primary health care settings. In South Africa most malaria infections are due to Plasmodium falciparum, and HRPII-based MRDTs have been used since 2001. Previous studies in Africa showed variability in sensitivity and specificity of HRPIIbased MRDTs; hence, we conducted a field evaluation in Limpopo province to determine the accuracy of the MRDT currently used in public sector clinics and hospitals. METHODS: A cross-sectional observational study was conducted to determine the sensitivity and specificity of an ICT Pf MRDT. We tested 405 patients with fever with ICT Pf MRDT and compared the results with blood film microscopy (the gold standard). RESULTS: The overall sensitivity of the ICT Pf MRDT was 99.48% (95% confidence interval (CI) 96.17 - 100%), while specificity was 96.26% (95% CI 94.7 - 100%). The positive predictive value of the test was 98.48 (99% CI 98.41 - 100%), and the negative predictive value was 99.52% (95% CI 96.47 - 100%). CONCLUSIONS: The ICT Pf MRDT is an appropriate test to use in the field in South Africa where laboratory facilities are not available. It has a high degree of sensitivity and acceptable level of specificity in accordance with the World Health Organization criteria. However, sensitivity of MRDT at low levels of parasitaemia (<100 parasites/µl of blood) in field conditions must still be established.

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Main Authors: Moonasar,Devanand, Goga,Ameena E, Kruger,Philip S, La Cock,Christine, Maharaj,Rajendra, Frean,John, Chandramohan,Daniel
Format: Digital revista
Language:English
Published: South African Medical Association 2009
Online Access:http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009001100023
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spelling oai:scielo:S0256-957420090011000232010-09-14Field evaluation of a malaria rapid diagnostic test (ICT Pf)Moonasar,DevanandGoga,Ameena EKruger,Philip SLa Cock,ChristineMaharaj,RajendraFrean,JohnChandramohan,DanielBACKGROUND: Malaria rapid diagnostic tests (MRDTs) are quick and easy to perform and useful for diagnosing malaria in primary health care settings. In South Africa most malaria infections are due to Plasmodium falciparum, and HRPII-based MRDTs have been used since 2001. Previous studies in Africa showed variability in sensitivity and specificity of HRPIIbased MRDTs; hence, we conducted a field evaluation in Limpopo province to determine the accuracy of the MRDT currently used in public sector clinics and hospitals. METHODS: A cross-sectional observational study was conducted to determine the sensitivity and specificity of an ICT Pf MRDT. We tested 405 patients with fever with ICT Pf MRDT and compared the results with blood film microscopy (the gold standard). RESULTS: The overall sensitivity of the ICT Pf MRDT was 99.48% (95% confidence interval (CI) 96.17 - 100%), while specificity was 96.26% (95% CI 94.7 - 100%). The positive predictive value of the test was 98.48 (99% CI 98.41 - 100%), and the negative predictive value was 99.52% (95% CI 96.47 - 100%). CONCLUSIONS: The ICT Pf MRDT is an appropriate test to use in the field in South Africa where laboratory facilities are not available. It has a high degree of sensitivity and acceptable level of specificity in accordance with the World Health Organization criteria. However, sensitivity of MRDT at low levels of parasitaemia (<100 parasites/µl of blood) in field conditions must still be established.South African Medical AssociationSAMJ: South African Medical Journal v.99 n.11 20092009-11-01journal articletext/htmlhttp://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009001100023en
institution SCIELO
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country Sudáfrica
countrycode ZA
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databasecode rev-scielo-za
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libraryname SciELO
language English
format Digital
author Moonasar,Devanand
Goga,Ameena E
Kruger,Philip S
La Cock,Christine
Maharaj,Rajendra
Frean,John
Chandramohan,Daniel
spellingShingle Moonasar,Devanand
Goga,Ameena E
Kruger,Philip S
La Cock,Christine
Maharaj,Rajendra
Frean,John
Chandramohan,Daniel
Field evaluation of a malaria rapid diagnostic test (ICT Pf)
author_facet Moonasar,Devanand
Goga,Ameena E
Kruger,Philip S
La Cock,Christine
Maharaj,Rajendra
Frean,John
Chandramohan,Daniel
author_sort Moonasar,Devanand
title Field evaluation of a malaria rapid diagnostic test (ICT Pf)
title_short Field evaluation of a malaria rapid diagnostic test (ICT Pf)
title_full Field evaluation of a malaria rapid diagnostic test (ICT Pf)
title_fullStr Field evaluation of a malaria rapid diagnostic test (ICT Pf)
title_full_unstemmed Field evaluation of a malaria rapid diagnostic test (ICT Pf)
title_sort field evaluation of a malaria rapid diagnostic test (ict pf)
description BACKGROUND: Malaria rapid diagnostic tests (MRDTs) are quick and easy to perform and useful for diagnosing malaria in primary health care settings. In South Africa most malaria infections are due to Plasmodium falciparum, and HRPII-based MRDTs have been used since 2001. Previous studies in Africa showed variability in sensitivity and specificity of HRPIIbased MRDTs; hence, we conducted a field evaluation in Limpopo province to determine the accuracy of the MRDT currently used in public sector clinics and hospitals. METHODS: A cross-sectional observational study was conducted to determine the sensitivity and specificity of an ICT Pf MRDT. We tested 405 patients with fever with ICT Pf MRDT and compared the results with blood film microscopy (the gold standard). RESULTS: The overall sensitivity of the ICT Pf MRDT was 99.48% (95% confidence interval (CI) 96.17 - 100%), while specificity was 96.26% (95% CI 94.7 - 100%). The positive predictive value of the test was 98.48 (99% CI 98.41 - 100%), and the negative predictive value was 99.52% (95% CI 96.47 - 100%). CONCLUSIONS: The ICT Pf MRDT is an appropriate test to use in the field in South Africa where laboratory facilities are not available. It has a high degree of sensitivity and acceptable level of specificity in accordance with the World Health Organization criteria. However, sensitivity of MRDT at low levels of parasitaemia (<100 parasites/µl of blood) in field conditions must still be established.
publisher South African Medical Association
publishDate 2009
url http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009001100023
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