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EVALUATION OF A MALARIA RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA DURING PREGNANCY

Plasmodium falciparum infection during pregnancy may cause placental malaria and subsequently low birth weight, primarily through the placental sequestration of infected red blood cells. Measuring the burden of malaria during pregnancy usually involves determining the prevalence of placental malaria infection through microscopic examination of placental blood films, a difficult and error-prone process. A number of rapid diagnostic tests (RDTs) for malaria have been developed, most of them immunochromatographic dipstick assays. However, none have been tested for the direct determination of malaria antigen in placental blood. We undertook an evaluation of the Malaria Rapid Test (MAKROmed^®) in determining placental malaria infection. The prevalence of placental parasitemia was 22.6% by microscopy, 51.0% by a polymerase chain reaction (PCR), and 43.1% by RDT. When the PCR was used as the gold standard, RDTs had a sensitivity of 89% and a specificity of 76%. The MAKROmed RDT was highly sensitive in the detection of placental malaria, but had lower than expected specificity.

Received December 15, 2003. Accepted for publication February 4, 2004.

Acknowledgments: We thank Dr. Paul Blumenthal (Johns Hopkins University, Baltimore, MD) for support, the study staff in Burkina Faso, and the women who participated in this study.

Financial support: This study was supported by the Centers for Disease Control and Prevention, the U.S. Agency for International Development, and the JHPIEGO Corporation.

Disclaimer: Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Service

Authors’ addresses: Lauren M. Singer, Robert D. Newman, Curtis S. Huber, Gail Stennies, John Barnwell, and Monica E. Parise, Malaria Branch, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway NE, Atlanta, GA 30341, Telephone: 770-488-7755, Fax: 770-488-4206. Amidou Diarra, Sodiomon B. Sirima, Amadou Konate, and Romial Sawadogo, Centre National de Recherche et de Formation sur le Paludisme, 01 BP 2208, Ouagadougou, Burkina Faso, Telephone: 226-32-46-95, Fax: 226-31-04-77. Allisyn C. Moran and Mathias Yameogo, Maternal and Neonatal Health, JHPIEGO Corporation, 1615 Thames Street, Suite 100, Baltimore, MD 21231, Telephone: 410-537-1891, Fax: 410-537-1479.

Reprint requests: Robert D. Newman, Malaria Branch, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway NE, Atlanta, GA 30341, Telephone: 770-488-7755, Fax: 770-488-4206, E-mail ren5{at}cdc.gov.

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