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Performance of a Histidine-Rich Protein 2 Rapid Diagnostic Test, Paracheck Pf®, for Detection of Malaria Infections in Ugandan Pregnant Women
Improved laboratory diagnosis is critical to reduce the burden of malaria in pregnancy. Peripheral blood smears appear less sensitive than Plasmodium falciparum histidine-rich protein 2–based rapid diagnostic tests (RDTs) for placental malaria infections in studies conducted at delivery. In this study, 81 women in Uganda in the second or third trimester of pregnancy were followed-up until delivery. At each visit, peripheral blood was tested by blood smear, RDT, and nested species-specific polymerase chain reaction (PCR). Sensitivity and specificity of the tests was calculated with PCR, which detected 22 infections of P. falciparum, as the gold standard. The sensitivity and specificity of blood smears were 36.4% (95% confidence interval [CI] = 18.0–59.2%) and 99.6% (95% CI = 97.7–100%), respectively. The corresponding values for RDT were 31.8% (95% CI = 14.7–54.9%) and 100% (95% CI = 98.3–100%). The RDTs could replace blood smears for diagnosis of malaria in pregnancy by virtue of their relative ease of use. Field-based sensitive tests for malaria in pregnancy are urgently needed.
Author Notes
Financial support: This study was sponsored by Médecins Sans Frontières and received additional financial support from the European Commission and the AEDES Foundation.
Authors' addresses: Mehul Dhorda, 11th Floor, Chamlong Harinasuta Building, Ratchathewi, Bangkok, Thailand, E-mail: mehul.dhorda@gmail.com. Patrice Piola and Philippe J. Guerin, Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Old Road, Oxford, United Kingdom, E-mails: patrice.piola@wwarn.org and philippe.guerin@wwarn.org. Dan Nyehangane, Benon Tumwebaze, Aisha Nalusaji, Carolyn Nabasumba, and Eleanor Turyakira, Epicentre Mbarara, Mbarara, Uganda, E-mails: dan.nyehangane@epicentre.msf.org, benontumwebaze@yahoo.com, aishanalusaji@yahoo.com, carolyn.nabasumba@epicentre.msf.org, and eleanor.turyakira@epicentre.msf.org. Rose McGready, Shoklo Malaria Research Unit, Mae Sot Tak, Thailand, E-mail: Email: rose@shoklo-unit.com. Elizabeth Ashley, Epicentre, Paris, France, E-mail: e.ashley@doctors.org.uk. Georges Snounou, Unité Mixte de Recherche 945, Institut National de la Santé et de la Recherche Médicale, Paris, France and Université Pierre et Marie Curie, Faculté de Médecine Pitié-Salpêtriére, 91 Boulevard de l'Hôpital, Paris, France, E-mail: georges.snounou@upmc.fr.