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    Jan 23, 2021
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    Paracheck-Pf accuracy and recently treated Plasmodium falciparum infections: is there a risk of over-diagnosis?

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    Authors
    Swarthout, T D
    Counihan, H
    Senga, R K K
    van den Broek, I
    Affiliation
    Médecins Sans Frontières, London, UK. toddswarth@yahoo.com
    Issue Date
    2007
    
    Metadata
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    Journal
    Malaria Journal
    Abstract
    BACKGROUND: An assessment of the accuracy of Paracheck Pf, a malaria rapid diagnostic test (RDT) detecting histidine rich protein 2 was undertaken amongst children aged 6-59 months in eastern Democratic Republic of Congo. METHODS: This RDT assessment occurred in conjunction with an ACT efficacy trial. Febrile children were simultaneously screened with both RDT and high quality microscopy and those meeting inclusion criteria were followed for 35 days. RESULTS: 358 febrile children were screened with 180 children recruited for five weeks follow-up. On screening, the RDT accurately diagnosed all 235 true malaria cases, indicating 100% RDT sensitivity. Of the 123 negative slides, the RDT gave 59 false-positive results, indicating 52.0% (64/123) RDT specificity. During follow-up after treatment with an artemisinin-based combination therapy, 98.2% (110/112), 94.6% (106/112), 92.0% (103/112) and 73.5% (50/68) of effectively treated children were still false-positive by RDT at days 14, 21, 28 and 35, respectively. CONCLUSION: Results show that though the use of Paracheck-Pf is as sensitive as microscopy in detecting true malaria cases, a low specificity did present a high frequency of false-positive RDT results. What's more, a duration of RDT false-positivity was found that significantly surpassed the 'fortnight' after effective treatment reported by its manufacturer. Though further research is needed in assessing RDT accuracy, study results showing the presence of frequent false positivity should be taken into consideration to avoid clinicians inappropriately focusing on malaria, not identifying the true cause of illness, and providing unnecessary treatment.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/17738
    DOI
    10.1186/1475-2875-6-58
    PubMed ID
    17506881
    Additional Links
    http://www.thelancet.com
    Language
    en
    ISSN
    1475-2875
    ae974a485f413a2113503eed53cd6c53
    10.1186/1475-2875-6-58
    Scopus Count
    Collections
    Malaria

    entitlement

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