Wongsrichanalai C, Arevalo I, Laoboonchai A, Yingyuen K, Miller RS, Magill AJ, Forney JR, Gasser RA Jr, 2003. Rapid diagnostic devices for malaria: field evaluation of a new prototype immunochromatographic assay for the detection of Plasmodium falciparum and non-falciparum Plasmodium. Am J Trop Med Hyg 69 :26–30.
Moody A, 2002. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 15 :66–78.
Murray CK, Bell D, Gasser RA, Wongsrichanalai C, 2003. Rapid diagnostic testing for malaria. Trop Med Int Health 8 :876–883.
Marx A, Pewsner D, Egger M, Nuesch R, Bucher HC, Genton B, Hatz C, Juni P, 2005. Meta-analysis: Accuracy of rapid tests for malaria in travelers returning from endemic areas. Ann Intern Med 142 :836–846.
McKenzie FE, Sirichaisinthop J, Miller RS, Gasser RA Jr, Wongsrichanalai C, 2003. Dependence of malaria detection and species diagnosis by microscopy on parasite density. Am J Trop Med Hyg 69 :372–376.
Hanscheid T, 1999. Diagnosis of malaria: A review of alternatives to conventional microscopy. Clin Lab Haematol 21 :235–245.
Namsiripongpun V, Wilde H, Pamsandang P, Tiersansern P, 1993. Field study of an antigen-detection ELISA specific for Plasmodium falciparum malaria. Trans R Soc Trop Med Hyg 87 :32–34.
Noedl H, Attlmayr B, Wernsdorfer WH, Kollaritsch H, Miller RS, 2004. A histidine-rich protein 2-based malaria drug sensitivity assay for field use. Am J Trop Med Hyg 71 :711–714.
Mackey LJ, McGregor IA, Paounova N, Lambert PH, 1982. Diagnosis of Plasmodium falciparum infection in man: Detection of parasite antigens by ELISA. Bull World Health Organ 60 :69–75.
Laoboonchai A, Kawamoto F, Thanoosingha N, Kojima S, Miller RS, Kain KC, Wongsrichanalai C, 2001. PCR-based ELISA technique for malaria diagnosis of specimens from Thailand. Trop Med Int Health 6 :458–462.
Clopper CJ, Pearson ES, 1934. The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26 :404–413.
Choudhury N, Jolly JG, Mahajan RC, Ganguly NK, Dubey ML, Agnihotri SK, 1991. Malaria screening to prevent transmission by transfusion: An evaluation of techniques. Med Lab Sci 48 :206–211.
Coleman RE, Maneechai N, Rachapaew N, Kumpitak C, Soyseng V, Miller RS, Thimasarn K, Sattabongkot J, 2002. Field evaluation of the ICT malaria Pf/Pv immunochromatographic test for the detection of asymptomatic malaria in a Plasmodium falciparum/vivax endemic area in Thailand. Am J Trop Med Hyg 66 :379–383.
Mayxay M, Pukritrayakamee S, Chotivanich K, Imwong M, Looareesuwan S, White NJ, 2001. Identification of cryptic coinfection with Plasmodium falciparum in patients presenting with vivax malaria. Am J Trop Med Hyg 65 :588–592.
Noedl H, Wongsrichanalai C, Miller RS, Myint KS, Looareesuwan S, Sukthana Y, Wongchotigul V, Kollaritsch H, Wiedermann G, Wernsdorfer WH, 2002. Plasmodium falciparum: Effect of anti-malarial drugs on the production and secretion characteristics of histidine-rich protein II. Exp Parasitol 102 :157–163.
Desakorn V, Silamut K, Angus B, Sahassananda D, Chotivanich K, Suntharasamai P, Simpson J, White NJ, 1997. Semi-quantitative measurement of Plasmodium falciparum antigen PfHRP2 in blood and plasma. Trans R Soc Trop Med Hyg 91 :479–483.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||575||161||3|
Enzyme-linked immunosorbent assays (ELISAs) allow for the testing of large numbers of samples within a short time frame. We tested the sensitivity and specificity of a histidine-rich protein 2 (HRP2)-based, commercially available ELISA antigen detection assay for Plasmodium falciparum (Malaria Antigen CELISA; Cellabs, Sydney, Australia). A total of 700 whole blood samples obtained from symptomatic outpatients of malaria clinics along the Thai–Myanmar border were tested relative to blinded duplicate expert microscopy adjusted with species-specific polymerase chain reaction (PCR). PCR-adjusted microscopy showed that 79 (11.3%) were infected with P. falciparum, 118 (16.9%) with P. vivax, 1 (0.1%) with P. malariae, 7 (1.0%) with mixed infections (P. falciparum and P. vivax), and 495 (70.7%) were negative. The geometric mean parasite density for P. falciparum was 7547/μL (range: 12–363,810/μL). The overall sensitivity of the HRP2 ELISA for P. falciparum malaria was 98.8% (95% CI, 93.6–100%) and the specificity was 100% (95% CI, 99.5–100%). The positive and negative predictive values for the ELISA were 100% (95% CI, 96.5–100%) and 99.8% (95% CI, 99.1–100%), respectively. The results for P. falciparum were clearly superior to expert microscopy alone, particularly in mixed infections. Microscopy combined with ELISA reaches a sensitivity and specificity similar to PCR-adjusted microscopy for the diagnosis of P. falciparum while being considerably less expensive and faster. We conclude that ELISA serves as an excellent tool to augment microscopy as the gold standard for P. falciparum diagnosis in research settings and should be further evaluated for screening in blood banks.