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Eyong EM, Etutu SJM, Jerome FC, Nyasa RB, Kwenti TE, Moyeh MN. Plasmodium falciparum histidine-rich protein 2 and 3 gene deletion in the Mount Cameroon region. IJID REGIONS (ONLINE) 2022; 3:300-307. [PMID: 35755467 PMCID: PMC9216387 DOI: 10.1016/j.ijregi.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/04/2022]
Abstract
pfhrp2/3 gene deletions occur in parasite populations in the Mount Cameroon region pfhrp2-negative parasites are the more common in the Mount Cameroon region pfhrp2/3-negative parasites negatively impact malaria rapid diagnostic test success
Objective Plasmodium falciparum produces histidine-rich protein 2/3 (Pfhrp2/3) genes that accumulate to high levels in the bloodstream and serve as a diagnostic and prognostic marker for falciparum malaria. Pfhrp2/3 gene deletions may lead to false-negative rapid diagnostic test (RDT) results. We aimed to determine the prevalence of pfhrp2/3 gene deletions in P. falciparum isolates and the implications for RDT use in the Mount Cameroon region. Methods A cross-sectional hospital-based study with malaria diagnosis performed using microscopy, RDT and nested polymerase chain reaction (nPCR). In total, 324 P. falciparum microscopy positive individuals were enrolled and their samples confirmed positive for P. falciparum using 18SrRNA PCR. Samples that gave false-negative RDT results were analyzed to detect pfhrp2/3 exon 2 deletions. Results Of 324 positive microscopic and nPCR samples, 16 gave RDT false-negative results. Among the 324 P. falciparum positive isolates, exon 2 deletions were observed in 2.2% (7 of 324); 3 were negative for pfhrp2 gene, 2 for pfhrp3, and 2 for both pfhrp2 and pfhrp3 (double deletions). Conclusion P. falciparum isolates with pfhrp2/3 gene deletion were present in the parasite populations and may contribute to the RDT false-negative results in the Mount Cameroon region.
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Affiliation(s)
- Esum Mathias Eyong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Sophie Jose Molua Etutu
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Fru-Cho Jerome
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Raymond Babila Nyasa
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Tebit Emmanuel Kwenti
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Marcel N Moyeh
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region of Cameroon
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Diagnostic Accuracy of CareStart™ Malaria HRP2 and SD Bioline Pf/PAN for Malaria in Febrile Outpatients in Varying Malaria Transmission Settings in Cameroon. Diagnostics (Basel) 2021; 11:diagnostics11091556. [PMID: 34573898 PMCID: PMC8469216 DOI: 10.3390/diagnostics11091556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
Background: There was an increase in the number of malaria cases in Cameroon in 2018 that could reflect changes in provider practice, despite effective interventions. In this study, we assessed the diagnostic performance of two malaria rapid diagnostic tests (mRDTs) for diagnostic confirmation of suspected cases of malaria in public and private health facilities in two malaria transmission settings in Cameroon. Methods: We evaluated the diagnostic performance of CareStart pf and SD Bioline Pf/PAN mRDT and compared these parameters by RDT type and transmission setting. Nested PCR and blood film microscopy were used as references. The chi square test was used for independent sample comparisons, while the McNemar’s test was used to test for the dependence of categorical data in paired sample testing. A p < 0.05 was considered significant in all comparisons. The R (v.4.0.2) software was used for analyses. Results: A total of 1126 participants consented for the study in the four sites. The diagnostic accuracy of the CareStart Pf mRDT was 0.93.6% (0.911–0.961) in Yaoundé, 0.930% (0.90–0.960) in Ngounso, 0.84% (0.794–0.891) in St Vincent Catholic Hospital Dschang and 0.407 (0.345–0.468) in Dschang district hospital. For SD Bioline Pf/PAN the accuracy was 0.759 (0.738–0.846) for St Vincent Catholic Hospital Dschang and 0.426 (0.372–0.496) for the Dschang district hospital. The accuracy was slightly lower in each case but not statistically different when PCR was considered as the reference. The likelihood ratios of the positive and negative tests were high in the high transmission settings of Yaoundé (10.99 (6.24–19.35)) and Ngounso (14.40 (7.89–26.28)) compared to the low transmission settings of Dschang (0.71 (0.37–1.37)) and St Vincent Catholic hospital (7.37 (4.32−12.59)). There was a high degree of agreement between the tests in Yaoundé (Cohen’s Kappa: 0.85 ± 0.05 (0.7–0.95)) and Ngounso (Cohen’s Kappa: 0.86 ± 0.05 (0.74, 0.97)) and moderate agreement in St Vincent hospital Dschang (k: 0.58 ± 0.06 (0.44–0.71)) and poor agreement in the District Hospital Dschang (Cohen’s Kappa: −0.11 ± 0.05 (−0.21–0.01)). The diagnostic indicators of the SD Bioline Pf/PAN were slightly better than for CareStart Pf mRDT in St Vincent Catholic hospital Dschang, irrespective of the reference test. Conclusions: Publicly procured malaria rapid diagnostic tests in Cameroon have maintained high accuracy (91–94%) in the clinical diagnosis of malaria in high malaria transmission regions of Cameroon, although they failed to reach WHO standards. We observed an exception in the low transmission region of Dschang, West region, where the accuracy tended to be lower and variable between facilities located in this town. These results underscore the importance of the routine monitoring of the quality and performance of malaria RDTs in diverse settings in malaria endemic areas.
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Nana RRD, Makoge V, Ngum NL, Amvongo-Adjia N, Singh V, Somo RM. Evaluating the dual reactivity on SD bioline malaria rapid diagnosis tests as a potential indicator of high parasitemia due to Plasmodium falciparum. Pathog Glob Health 2021; 115:487-495. [PMID: 34309493 DOI: 10.1080/20477724.2021.1953684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The co-reactivity of the Plasmodium histidine-rich protein 2 (HRP2) and lactate dehydrogenase (pLDH) in malaria rapid diagnosis tests (mRDTs) as a potential indicator of high parasitemia linked to Plasmodium falciparum was evaluated in the reported study from Cameroon. The samples were screened for malaria using both mRDTs (SD bioline HRP2/pLDH), light microscopy and further confirmed by Plasmodium species-specific PCR assay. Of the 483 patients enrolled, 161 (33.3%) showed a reactive mRDTs amongst which 70 patients were positive by both microscopy and mRDTs with 30.0% (21/70) positive for HRP2 alone, while 70.0% (49/70) showed a dual reaction to HRP2 and pLDH parasite antigens. P. falciparum parasitemia was found to be significantly high among patients with both reactive antigens, (p < 0.0001) suggesting that mRDTs reactivity is influenced by parasite load which could be used as a diagnostic marker for therapeutic management of patients with high parasitemia in field conditions.
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Affiliation(s)
- Roman Rodrigue Dongang Nana
- CWll Biology and Malaria Parasite Bank, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India.,Department of Microbiology, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Valerie Makoge
- Department of Microbiology, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Ngum Lesley Ngum
- Department of Microbiology, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Nathalie Amvongo-Adjia
- Department of Microbiology, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Vineeta Singh
- CWll Biology and Malaria Parasite Bank, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Roger Moyou Somo
- Department of Microbiology, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon.,Department of Microbiology, Hematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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4
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Mubanga C, Mwape KE, Phiri IK, Trevisan C, Kabululu M, Zulu G, Van Damme I, Schmidt V, Dorny P, Gabriël S. Operational characteristics of an antibody detecting point of care test for Taenia solium infections in a community and hospital setting. BMC Infect Dis 2021; 21:607. [PMID: 34172004 PMCID: PMC8235832 DOI: 10.1186/s12879-021-06320-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/09/2021] [Indexed: 01/22/2023] Open
Abstract
Background Diagnostic test evaluation includes measures of performance and assessment of operational characteristics. The latter focuses on end-user understanding of instructions to perform the test, ease of use, test turnaround time and ease of result interpretation. This study aimed to assess user comprehension of training for and ease of use of a Taenia solium point of care test (TS POC) evaluated in a community and hospital setting in Zambia and Tanzania, respectively. Methods The TS POC is a three-step in-house-produced rapid diagnostic test (RDT) for the simultaneous detection of taeniosis (TST) and cysticercosis (TSCC) antibodies. Data collected by administering questionnaires to 29 end-users and from the main evaluation database was analyzed quantitatively. Results End-users (28/29, 97%) perceived that the training they received for performing the test was sufficient. They performed 4080 tests, of which 80 were invalid. The community-based study and TST tests had higher invalid rates. The overall result interpretation was within the acceptable range of RDTs with an overall disagreement between readers of 3.3%. The Kappa coefficient of agreement was 85 and 82% for TSCC and TST, respectively. There was more disagreement among readers in the community-based study. Conclusion End-users rated the TS POC kit moderate in terms of ease of use citing long test turnaround time and difficulties in using the blood transfer device. Overall, the operational performance of the TS POC kit and end-users was within the established acceptable performance range. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06320-3.
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Affiliation(s)
- Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia. .,Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mwemezi Kabululu
- Tanzania Livestock Research Institute (TALIRI) - Uyole, P. O. Box 6191, Mbeya, Tanzania
| | - Gideon Zulu
- Provincial Health Office, Ministry of Health, Chipata, Zambia
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Veronika Schmidt
- Department of Neurology, Centre for Global Health, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Virology, Parasitology, and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Kojom Foko LP, Kouemo Motse FD, Kamgain Mawabo L, Pande V, Singh V. First evidence of local circulation of Plasmodium ovale curtisi and reliability of a malaria rapid diagnostic test among symptomatic outpatients in Douala, Cameroon. INFECTION GENETICS AND EVOLUTION 2021; 91:104797. [PMID: 33676011 DOI: 10.1016/j.meegid.2021.104797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/14/2021] [Accepted: 03/01/2021] [Indexed: 11/18/2022]
Abstract
The performances of a commonly used Plasmodium falciparum-detecting rapid diagnostic test (RDT) were determined in symptomatic individuals living in Cameroon. Discrepancies between RDT and light microscopy (LM) results were further investigated, with a focus on non-falciparum malaria (NFM) which are still largely understudied in sub-Saharan Africa (sSA) countries. In the present study, a total of 355 individuals aged 1-65 years were enrolled in the study. Their signs/symptoms and sociodemographic characteristics were documented. The RDT reliability was evaluated using LM as gold standard method. Polymerase chain reaction (PCR) of Plasmodium 18S gene was performed for samples with discordant results between LM and RDT (i.e., RDT-/LM+, and RDT+/LM-). The PCR amplicons of NFM species were sequenced and BLASTed. The prevalence of malaria infection by LM was 95.7% (95% CI: 93.1-97.4%). The sensitivity and specificity of RDT for P. falciparum detection was 94.0% and 66.7%, respectively. By PCR assay, P. ovale curtisi (PoC) was found in 5 of the 30 discordant samples, and on sequence analysis these isolates were found to be phylogenetically closer to sequences reported from China-Myanmar border and Malaysia. This is the first report on molecular characterization of P. ovale subspecies in Cameroon. The study also outlines the good diagnostic performances of the RDT for detection of P. falciparum. Though, the presence of PoC indicated the importance of having RDTs targeting the NFM species in malaria diagnosis and treatment, which is presently limited in the country.
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Affiliation(s)
- Loick P Kojom Foko
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, New Delhi 110077, India; Department of Biotechnology, Faculty of Sciences, Kumaun University, Naini Tāl 263001, Uttarakhand, India
| | - Francine D Kouemo Motse
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | | | - Veena Pande
- Department of Biotechnology, Faculty of Sciences, Kumaun University, Naini Tāl 263001, Uttarakhand, India
| | - Vineeta Singh
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, New Delhi 110077, India.
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Gómez-Luque A, Parejo JC, Clavijo-Chamorro MZ, López-Espuela F, Munyaruguru F, Belinchón Lorenzo S, Monroy I, Gómez-Nieto LC. Method for Malaria Diagnosis Based on Extractions of Samples Using Non-Invasive Techniques: An Opportunity for the Nursing Clinical Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5551. [PMID: 32752015 PMCID: PMC7432767 DOI: 10.3390/ijerph17155551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022]
Abstract
Malaria has been for millennia one of the best known and most destructive diseases affecting humans. Its high impact has aroused great interest for the development of new effective and reliable diagnostic techniques. Recently it has been recently published that hairs from mammal hosts are able to capture, hold and finally remove foreign DNA sequences of Leishmania parasites. The aim of this study was to check if Plasmodium falciparum (P. falciparum) DNA remains stable in blood samples deposited in Whatman paper after suffering different transport and storage conditions, and to compare the sensitivity of these results with those offered by thick a smear and Rapid Diagnostic Test, and besides to examine whether P. falciparum DNA would be detected and quantified by Real time quantitative PCR (qPCR) from hairs of people with different types of malaria. P. falciparum Histidine Repeat Protein II (pHRP-II) antigen detection and P. falciparum DNA were detected in 18 of 19 dry blood samples adhered to Whatman paper (94.74%), besides, Plasmodium DNA was also detected in seven out of 19 hair samples analyzed (36.84%), remaining stable until analysis for several months under the exposure to different environmental conditions. Although the sensitivity of PCR for the diagnosis of malaria in hair samples is not as high as blood analysis, the study of Plasmodium DNA presence in blood and hair could constitute a complementary tool with numerous advantages in sample collection, transport and storage. We suggest that the method could be also applied to medical, forensic and paleo-parasitological diagnosis, not only for malaria but also for searching many other pathogens in hair samples.
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Affiliation(s)
- Adela Gómez-Luque
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura s/n, 10003 Cáceres, Spain; (A.G.-L.); (M.Z.C.-C.)
| | - Juan Carlos Parejo
- Unidad de Genética, Facultad de Veterinaria, University of Extremadura s/n, 10003 Cáceres, Spain;
| | - Maria Zoraida Clavijo-Chamorro
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura s/n, 10003 Cáceres, Spain; (A.G.-L.); (M.Z.C.-C.)
| | - Fidel López-Espuela
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura s/n, 10003 Cáceres, Spain; (A.G.-L.); (M.Z.C.-C.)
| | | | - Silvia Belinchón Lorenzo
- Laboratorio LeishmanCeres, Unidad de Parasitología, Facultad de Veterinaria, University of Extremadura s/n, 10003 Cáceres, Spain; (S.B.L.); (I.M.); (L.C.G.-N.)
| | - Isabel Monroy
- Laboratorio LeishmanCeres, Unidad de Parasitología, Facultad de Veterinaria, University of Extremadura s/n, 10003 Cáceres, Spain; (S.B.L.); (I.M.); (L.C.G.-N.)
| | - Luis Carlos Gómez-Nieto
- Laboratorio LeishmanCeres, Unidad de Parasitología, Facultad de Veterinaria, University of Extremadura s/n, 10003 Cáceres, Spain; (S.B.L.); (I.M.); (L.C.G.-N.)
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Abstract
Diagnosing malaria is a key component of effective case management and monitoring of antimalarial programs worldwide. This chapter features the different diagnostic approaches currently in use or under testing for use in case management and/or epidemiological studies of malaria. Emphasis is laid on the basic principles of each diagnostic approach as well as their operational limits under different malaria endemicity settings. The discussed methods are defined as "conventional" or "unconventional" depending on their widespread use in malaria case management. The chapter therefore provides a practical guide to students, health practitioners, and field researchers involved in the fight against malaria through community-based interventions.
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Kojom LP, Singh V. Prevalence of Plasmodium falciparum field isolates with deletions in histidine-rich protein 2 and 3 genes in context with sub-Saharan Africa and India: a systematic review and meta-analysis. Malar J 2020; 19:46. [PMID: 31992330 PMCID: PMC6986054 DOI: 10.1186/s12936-019-3090-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/25/2019] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND In 2017, nearly 80% of malaria morbidity and mortality occurred in sub-Saharan African (SSA) countries and India. Rapid diagnostic tests (RDTs), especially those targeting histidine-rich protein 2 (PfHRP2) of Plasmodium falciparum, have become an important diagnostic tool in these malaria-endemic areas. However, the chances of RDT-oriented successful treatment are increasingly jeopardized by the appearance of mutants with deletions in pfhrp2 and pfhrp3 genes. This systematic review and meta-analysis determines the prevalence of field P. falciparum isolates with deletion in pfhrp2 and/or pfhrp3 genes and their proportion among false-negative results in the PfHRP2-based RDTs in SSA and India. METHODS Eight electronic databases were used for searching potentially relevant publications for the systematic review analysis, wherein the main methodological aspects of included studies were analysed and some missing links in the included studies were identified. RESULTS A total of 19 studies were included, 16 from SSA and 3 from India. The pooled prevalence of pfhrp2 deletions was 8 and 5% while 16 and 4% for pfhrp3 gene deletions in Africa and India, respectively. The pooled proportion of pfhrp2 gene deletions found among false negative PfHRP2-based RDTs results was about 27.0 and 69.0% in Africa and India, respectively. CONCLUSIONS This review study indicates a relatively high proportion of both pfhrp2/3 genes deletions in P. falciparum isolates and among false-negative malaria cases using PfHRP2-based RDT results in SSA and India. Recently the deletions in pfhrp2/3 genes have also been reported from two African countries (Nigeria and Sudan). This review emphasizes the importance of more extensive studies and standardization of studies addressing the pfhrp2/3 gene deletions in malarious areas.
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Affiliation(s)
- Loick P Kojom
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi, 110077, India
| | - Vineeta Singh
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi, 110077, India.
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Nkenfou CN, Hell VN, Georges NT, Ngoufack MN, Nkenfou CN, Kamgaing N, Ndjolo A. USAGE OF A RAPID DIAGNOSTIC TEST FOR MALARIA IN CHILDREN. Afr J Infect Dis 2018; 13:24-31. [PMID: 30596193 PMCID: PMC6305079 DOI: 10.21010/ajid.v13i1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/14/2017] [Accepted: 07/12/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Malaria is still the primary cause of pediatric deaths. The efficient management of pediatric malaria requires its rapid and accurate diagnosis. To fulfill this requirement, rapid diagnostic tests have been developed, but their evaluation before commercialization is never exhaustive. The aim of this study was to evaluate the performance of a rapid diagnostic test (SD Bioline Malaria Antigen P.f/Pan) to diagnose malaria in children. MATERIALS AND METHODS Testing was conducted on children aged between 6 months and 15 years who were examined at the "Centre Mère Enfant (CME) of the "Chantal Biya" Foundation (FCB). as a result of fever. Enrollment took place from April to October 2014. All children presenting with fever were sampled (3ml of blood). These blood samples were tested for malaria using microscopy on a thick blood smear and by a rapid diagnostic test (RDT) SD Bioline Malariae Antigen P.f/Pan. RESULTS A total of 249 children were enrolled in this study. Malaria presence as determined by microscopy and by RDT was 30.9% and 58.2% respectively. The sensitivity, specificity, positive and negative predictive values compared to microscopy were: 75; 48.8; 39, and 81.6%. With these performances, the malaria SD Bioline rapid test presents lower values compared to WHO recommendations for rapid tests (sensitivity > 95%) in children. CONCLUSION SD Bioline Malaria Antigen P.f/Pan test should only be used in peripheral health structures that lack resources, and should be aided by clinical diagnosis.
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Affiliation(s)
- Céline Nguefeu Nkenfou
- Laboratory of Systems Biology, “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CBIRC), Yaounde, Cameroon
- Department of Biological Sciences, Higher Teacher Training College, University of Yaounde I, Yaounde, Cameroon
| | - Vestale Ngo Hell
- Catholic University, School of Health Sciences, Yaounde, Cameroon
| | | | - Marie Nicole Ngoufack
- Laboratory of Systems Biology, “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CBIRC), Yaounde, Cameroon
- Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | - Nelly Kamgaing
- Laboratory of Systems Biology, “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CBIRC), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Alexis Ndjolo
- Laboratory of Systems Biology, “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CBIRC), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
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Tchuandom SB, Tchouangueu TF, Antonio-Nkondjio C, Lissom A, Djang JON, Atabonkeng EP, Kechia A, Nchinda G, Kuiate JR. Seroprevalence of dengue virus among children presenting with febrile illness in some public health facilities in Cameroon. Pan Afr Med J 2018; 31:177. [PMID: 31086629 PMCID: PMC6488248 DOI: 10.11604/pamj.2018.31.177.16390] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/21/2018] [Indexed: 01/05/2023] Open
Abstract
Introduction A routine diagnosis of Dengue virus (DENV) infection is not usually conducted in hospitals. Because symptoms overlap, many potential febrile illnesses due to DENV may be confused for malaria, typhoid or paratyphoid (enteric) fever. The absence of data on DENV exposure rates among children attending health facilities could undermine management of this disease. This study aimed to investigate the seroprevalence of dengue virus infection in children presenting febrile illness in some public health facilities in Cameroon. Methods A cross-sectional study was performed in children ≤ 15 years attending seven urban and three semi-urban public hospitals of Cameroon. From each volunteer, 2ml of whole blood was collected and tested for dengue virus IgM, malaria (Pf/Pan antigens) and enteric fever (Typhoid IgM) using rapid diagnostic tests (RDT); in order to allow the healthcare workers to quickly put the positive cases under appropriate treatment. Positive cases of dengue virus infection were confirmed by indirect ELISA. Data analysis were performed using the statistical package for social sciences software, version 22.1. Results A total of 961 children were enrolled in the study and 492 (51.2%) were infected with at least one of the three pathogens. Overall, DENV IgM seroprevalence among febrile children was 14.4% (138/961). About 390 (40.6%) and 22 (2.3%) had malaria (Pf/Pan Ag) and enteric fever (Typhoid IgM) respectively. Co-infection with dengue virus was found in 51 (5.3%) participants. The dengue virus IgM seroprevalence was higher in Bankim (19.3%), Ntui (18.3%) and Douala (18.2%). Conclusion Dengue virus infection seroprevalence appears to be low in children presenting with febrile illness in the studied health centres in Cameroon but call for more attention and research to further characterise the circulating strains of the dengue virus.
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Affiliation(s)
- Salomon Bonsi Tchuandom
- Department of Biochemistry, University of Dschang, Cameroon.,Public School of medical Laboratory Technicians, Yaoundé, Cameroon
| | - Thibau Flaurant Tchouangueu
- Department of Biochemistry, University of Dschang, Cameroon.,Laboratory of Microbiology and Immunology, Chantal Biya International Reference Centre for Research and Prevention on HIV/AIDS Yaoundé
| | - Christophe Antonio-Nkondjio
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroun
| | - Abel Lissom
- Department of Animal Biology and Physiology, University of Yaoundé 1, Yaoundé
| | | | | | | | - Godwin Nchinda
- Laboratory of Microbiology and Immunology, Chantal Biya International Reference Centre for Research and Prevention on HIV/AIDS Yaoundé
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Data set on Rapid Diagnostic Tests (RDTs) and microscopy for diagnosing plasmodium falciparum and plasmodium vivax. Data Brief 2018; 20:503-509. [PMID: 30182042 PMCID: PMC6120593 DOI: 10.1016/j.dib.2018.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/26/2018] [Accepted: 08/10/2018] [Indexed: 11/21/2022] Open
Abstract
The World Heal Organization (WHO) has identified malaria diagnosis as being pivotal to eradicating the disease by 2030 as stipulated in the Sustainable Development Goals (SDG). The data presented here was obtained from outpatients of a hospital in the South Western Region of Nigeria from November 2016 to May 2017. The data contains malaria incidence amongst asymptomatic and symptomatic outpatients in the period under review. Malaria incidence was obtained using two diagnostic test kits, Bioline SD (HRP-2) and ACON (HRP-2/Aldolase) alongside Microscopy as gold standard. Specificity, Sensitivity and Kappa statistic of each test device is presented in the tables herewith. Data presented here could be used alongside other data sources to assess the state of malaria diagnostics.
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Parr JB, Verity R, Doctor SM, Janko M, Carey-Ewend K, Turman BJ, Keeler C, Slater HC, Whitesell AN, Mwandagalirwa K, Ghani AC, Likwela JL, Tshefu AK, Emch M, Juliano JJ, Meshnick SR. Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey. J Infect Dis 2017; 216:36-44. [PMID: 28177502 DOI: 10.1093/infdis/jiw538] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/02/2016] [Indexed: 11/14/2022] Open
Abstract
Background Rapid diagnostic tests (RDTs) account for more than two-thirds of malaria diagnoses in Africa. Deletions of the Plasmodium falciparum hrp2 (pfhrp2) gene cause false-negative RDT results and have never been investigated on a national level. Spread of pfhrp2-deleted P. falciparum mutants, resistant to detection by HRP2-based RDTs, would represent a serious threat to malaria elimination efforts. Methods Using a nationally representative cross-sectional study of 7,137 children under five years of age from the Democratic Republic of Congo (DRC), we tested 783 subjects with RDT-/PCR+ results using PCR assays to detect and confirm deletions of the pfhrp2 gene. Spatial and population genetic analyses were employed to examine the distribution and evolution of these parasites. Results We identified 149 pfhrp2-deleted parasites, representing 6.4% of all P. falciparum infections country-wide (95% confidence interval 5.1-8.0%). Bayesian spatial analyses identified statistically significant clustering of pfhrp2 deletions near Kinshasa and Kivu. Population genetic analysis revealed significant genetic differentiation between wild-type and pfhrp2-deleted parasite populations (GST = .046, p ≤ .00001). Conclusions Pfhrp2-deleted P. falciparum is a common cause of RDT-/PCR+ malaria among asymptomatic children in the DRC and appears to be clustered within select communities. Surveillance for these deletions is needed, and alternatives to HRP2-specific RDTs may be necessary.
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Affiliation(s)
- Jonathan B Parr
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Robert Verity
- Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom
| | - Stephanie M Doctor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Mark Janko
- Department of Geography, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kelly Carey-Ewend
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Breanna J Turman
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Corinna Keeler
- Department of Geography, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Hannah C Slater
- Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom
| | - Amy N Whitesell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kashamuka Mwandagalirwa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Azra C Ghani
- Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom
| | - Joris L Likwela
- Programme National de la Lutte contre le Paludisme, Kinshasa, Democratic Republic of Congo
| | - Antoinette K Tshefu
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Geography, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jonathan J Juliano
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Steven R Meshnick
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
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Feleke DG, Tarko S, Hadush H. Performance comparison of CareStart™ HRP2/pLDH combo rapid malaria test with light microscopy in north-western Tigray, Ethiopia: a cross-sectional study. BMC Infect Dis 2017; 17:399. [PMID: 28587600 PMCID: PMC5461705 DOI: 10.1186/s12879-017-2503-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 05/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid diagnostic tests (RDTs) are alternative methods for microscopy in the diagnosis of malaria in resource limited settings. Among commercially available RDTs, CareStart™ Malaria test was found to show reliable results. This study evaluated the performance of CareStart™ Malaria Combo test kit in Northwestern Tigray in Ethiopia. METHODS Blood samples were collected from 320 malaria-suspected patients at Mayani Hospital in Northwestern Tigray from December 2015 to March 2016. All blood samples were examined using both light microscopy and CareStart™ Malaria HRP2/pLDH Combo Test kit. Statistical analyses were performed using SPSS version 20. RESULTS The overall parasite positivity using light microscopy and CareStart™ RDT was 41 (12.8%) and 43 (13.4%), respectively. The sensitivity and specificity of CareStart™ RDT, regardless of species, were found to be 95.4 and 99.3%, respectively. Furthermore, the sensitivity of CareStart™ RDT for Plasmodium falciparum or mixed infection and non-falciparum malaria parasites was 94.4 and 85.0%, respectively while the specificity was found to be 98.9 and 99.7%, respectively. The agreement between the two test methods was "excellent" with a kappa value of 0.92. CONCLUSION CareStart™ RDT has very good sensitivity and specificity for malaria diagnosis. The test kit also has an excellent agreement with light microscopy. It is therefore useful in resource-limited areas where microscopy is not available.
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Affiliation(s)
- Daniel Getacher Feleke
- Department of Biomedical Sciences, College of Health Sciences and Referral Hospital, Aksum University, Aksum, Ethiopia.
| | - Shambel Tarko
- School of Nursing, College of Health Sciences and Referral Hospital, Aksum University, Aksum, Ethiopia
| | - Haftom Hadush
- Department of Biomedical Sciences, College of Health Sciences and Referral Hospital, Aksum University, Aksum, Ethiopia
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Zhao Y, Zhao Y, Lv Y, Liu F, Wang Q, Li P, Zhao Z, Liu Y, Cui L, Fan Q, Cao Y. Comparison of methods for detecting asymptomatic malaria infections in the China-Myanmar border area. Malar J 2017; 16:159. [PMID: 28427455 PMCID: PMC5397696 DOI: 10.1186/s12936-017-1813-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/09/2017] [Indexed: 02/06/2023] Open
Abstract
Background Sensitive methods for detecting asymptomatic malaria infections are essential for identifying potential transmission reservoirs and obtaining an accurate assessment of malaria epidemiology in low-endemicity areas aiming to eliminate malaria. PCR techniques to detect parasite nucleic acids (DNA or RNA) are among the most commonly used molecular methods. However, most of these methods are of low throughput and cannot be used for large-scale molecular epidemiological studies. A recently developed capture and ligation probe-PCR (CLIP-PCR) is claimed to have the sensitivity of molecular techniques and the high throughput capacity needed for screening purposes. This study aimed to compare several molecular methods for detecting asymptomatic and submicroscopic Plasmodium infections in healthy residents of a malaria-hypoendemic region in Southeast Asia, where malaria elimination is in sight. Method This study compared three molecular detection methods side-by-side, namely nested PCR targeting the rRNA genes, nested RT-PCR to detect parasite rRNA, and CLIP-PCR to detect parasite rRNA in 1005 healthy individuals in northeastern Myanmar. For nested PCR and RT-PCR, parasite DNA and total RNA were extracted from ~100 µL of blood, whereas RNA used for CLIP-PCR was from a 3 mm disk of dried blood filter paper. The sensitivity and specificity of these methods were compared with those of conventional light microscopy. In addition, RT-PCR and quantitative RT-PCR (qRT-PCR) targeting the Pvs25 gene in Plasmodium vivax were used to assess gametocyte prevalence in the samples. Results Light microscopy detected Plasmodium infections in only 1.19% of the residents harbouring the parasites. CLIP-PCR had slightly better performance and detected Plasmodium infections in 1.89% of the population. Further improvement was achieved by nested PCR to detect parasite DNA, which detected P. vivax and Plasmodium falciparum infections in 2.39% of the residents. The nested RT-PCR targeting rRNA, however, detected as many as 187 (18.61%) individuals having Plasmodium infections with P. vivax being the predominant species (176 P. vivax, 5 P. falciparum and 6 P. falciparum/P. vivax mixed infections). Of the 210 Plasmodium-positive samples detected by all molecular methods, 115 were Pvs25-positive by qRT-PCR, indicating that a large proportion of asymptomatic individuals were gametocyte carriers. Conclusion Nested RT-PCR based on the detection of asexual-stage parasite rRNA was the most sensitive, with a more than sixfold higher sensitivity than the other two molecular methods of parasite detection. CLIP-PCR has an increased throughput, but its sensitivity in this study was much lower than those of other molecular methods, which may be partially due to the smaller amount of RNA input used. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1813-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yonghong Zhao
- Department of Immunology, China Medical University, Shenyang, Liaoning, China
| | - Yan Zhao
- Department of Immunology, China Medical University, Shenyang, Liaoning, China
| | - Yanmin Lv
- Department of Immunology, China Medical University, Shenyang, Liaoning, China
| | - Fei Liu
- Department of Immunology, China Medical University, Shenyang, Liaoning, China
| | - Qinghui Wang
- Department of Immunology, China Medical University, Shenyang, Liaoning, China
| | - Peipei Li
- Dalian Institute of Biotechnology, Dalian, Liaoning, China
| | - Zhenjun Zhao
- Dalian Institute of Biotechnology, Dalian, Liaoning, China
| | - Yingjie Liu
- Department of Pathogen Biology, China Medical University, Shenyang, Liaoning, China
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park, PA, USA.
| | - Qi Fan
- Dalian Institute of Biotechnology, Dalian, Liaoning, China.
| | - Yaming Cao
- Department of Immunology, China Medical University, Shenyang, Liaoning, China.
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Comparative Performance Evaluation of Routine Malaria Diagnosis at Ho Municipal Hospital. J Parasitol Res 2016; 2016:5837890. [PMID: 27747097 PMCID: PMC5055952 DOI: 10.1155/2016/5837890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/10/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022] Open
Abstract
Differences in quality performance score had been reported for the routinely used diagnostic methods for malaria at different settings. There is therefore a need to evaluate the test performance of the routine diagnostic methods for malaria detection in Ho, a setting with no recorded quality evaluation on malaria diagnosis. The hospital-based cross-sectional study was conducted comprising 299 outpatients. Patients were first seen and presumptively diagnosed with malaria by a clinician and were referred to the laboratory for confirmation (microscopy and Rapid Diagnostic Test). The performance analysis included sensitivity, specificity, receiver operating characteristics (ROC), weighted kappa, Youden index, and p value. Out of the 299 patients, 221 patients were positive by presumptive diagnosis, 35 were positive by Rapid Diagnostic Test (RDT), and 25 were positive by microscopy. Using microscopy as the gold standard, RDT had sensitivity of 62.5% and specificity of 92.73%, whilst presumptive diagnosis had a sensitivity of 70.83% and specificity of 25.82%. The RDT recorded ROC of 0.697 with p value of 0.0001. The presumptive diagnosis recorded ROC of 0.506 with p value of 0.7304. Though none of the test methods evaluated over the gold standard achieved the WHO recommended diagnostic sensitivity and specificity, the RDT achieved an acceptable agreement with the gold standard.
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