Abstract
BackgroundMalaria rapid diagnostic tests (RDTs) are a useful tool in endemic malaria countries, where light microscopy is not feasible. In non-endemic countries they can be used as complementary tests to provide timely results in case of microscopy inexperience. This study aims to compare the new VIKIA Malaria Ag Pf/Pan™ RDT with PCR-corrected microscopy results and the commonly used CareStart™ RDT to diagnose falciparum and non-falciparum malaria in the endemic setting of Bamako, Mali and the non-endemic setting of Lyon, France.MethodsBlood samples were collected during a 12-months and six-months period in 2011 from patients suspected to have malaria in Lyon and Bamako respectively. The samples were examined by light microscopy, the VIKIA Malaria Ag Pf/Pan™ test and in Bamako additionally with the CareStart™ RDT. Discordant results were corrected by real-time PCR. Sensitivity, specificity, positive predictive value and negative predictive value were used to evaluate test performance.ResultsSamples of 877 patients from both sites were included. The VIKIA Malaria Ag Pf/Pan™ had a sensitivity of 98% and 96% for Plasmodium falciparum in Lyon and Bamako, respectively, performing similar to PCR-corrected microscopy.ConclusionsThe VIKIA Malaria Ag Pf/Pan™ performs similar to PCR-corrected microscopy for the detection of P. falciparum, making it a valuable tool in malaria endemic and non-endemic regions.
Highlights
Malaria rapid diagnostic tests (RDTs) are a useful tool in endemic malaria countries, where light microscopy is not feasible
The secondary objective of the study was to compare data obtained from technicians working in a general health care centre located in an endemic area, daily exposed to a high number of malaria diagnosis, to those obtained by technicians from an European University Hospital where malaria is restricted to two imported case per week, on a yearly basis mean
According to the information given by the patients, anti-malarial chemoprophylaxis was regularly taken by 32% (n=22)
Summary
Malaria rapid diagnostic tests (RDTs) are a useful tool in endemic malaria countries, where light microscopy is not feasible. In non-endemic countries they can be used as complementary tests to provide timely results in case of microscopy inexperience. The number of courses of artemisinin combination therapy (ACT) still exceeds the total number of malaria diagnostic tests by a factor of 2, indicating that many patients receive ACT without confirmatory diagnosis [1]. Microscopy constrains in malaria endemic regions are the need for skilled laboratory technicians, good quality reagents and well-maintained microscopes as well as its time consumption [6]. Most laboratories in non-endemic countries lack sufficient samples to build-up and maintain microscopic expertise
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