Field Performances of Rapid Diagnostic Tests Detecting Human Plasmodium Species: A Systematic Review and Meta-Analysis in India, 1990-2020.

Loick Pradel Kojom Foko,Vineeta Singh,Veena Pande

doi:10.3390/diagnostics11040590

Loick Pradel Kojom Foko, Vineeta Singh + Show 1 more

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https://doi.org/10.3390/diagnostics11040590

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Abstract

Rapid diagnostic tests (RDTs) have become a mainstay of malaria diagnosis in endemic countries since their implementation in the 1990s. We conducted a 30-year systematic review and meta-analysis on malaria RDTs performance in India. Outcomes of interest were sensitivity (Se), specificity (Sp), positive/negative likelihood ratio (PLR/NLR), and diagnostic odd ratio (DOR). Among the 75 studies included, most of the studies were cross-sectional (65.3%), hospital-based (77.3%), and targeted febrile patients (90.6%). Nearly half of RDTs were designed for detecting Plasmodium falciparum only (47.5%) while the rest were for P. falciparum and P. vivax (11.9%), and P. falciparum/Pan-Plasmodium except for P. knowlesi (32.3%). When compared to light microscopy (gold standard), pooled estimates of performances were: Se = 97.0%, Sp = 96.0%, PLR = 22.4, NLR = 0.02 and DOR = 1080. In comparison to polymerase chain reaction, the RDTs showed Se = 89.0% and Sp = 99.0%. Performance outcomes (Se and Sp) were similar for RDT targeting P. falciparum only, but decreased for mixed and non-falciparum infections. Performances of malaria RDTs are still high India. However, there is a need for developing RDTs with regard to targeting minor malarial species, individuals carrying only mature gametocytes, and pfhrp2-deleted parasites.

Highlights

IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
false positive (FP) is seen in Rapid diagnostic tests (RDTs) targeting PfHRP2 protein, as this protein is detectable in the bloodstream for many weeks following successful treatment of infections [4]
This study outlines the need for development of RDTs for the detection of minor malaria species circulating in the country (i.e., P. ovale, P. malariae and P. knowlesi) to reach malaria elimination objectives

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Plasmodium falciparum and Plasmodium vivax are the main species contributing to the malaria burden worldwide. These protozoan parasites are transmitted to humans through infecting bites of female Anopheles mosquitoes [1]. Malaria is an important public health concern, with ~229 million of cases and 409,000 deaths reported in 2019 globally. In the current context of malaria control and elimination, many countries are scaling up strategies to achieve elimination objectives stated by the World Health Organisation (WHO) [2]

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