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Field evaluation of a PfHRP-2/pLDH rapid diagnostic test and light microscopy for diagnosis and screening of falciparum malaria during the peak seasonal transmission in an endemic area in Yemen

Overview of attention for article published in Malaria Journal, January 2016
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Title
Field evaluation of a PfHRP-2/pLDH rapid diagnostic test and light microscopy for diagnosis and screening of falciparum malaria during the peak seasonal transmission in an endemic area in Yemen
Published in
Malaria Journal, January 2016
DOI 10.1186/s12936-016-1103-2
Pubmed ID
Authors

Lina M. Q. Alareqi, Mohammed A. K. Mahdy, Yee-Ling Lau, Mun-Yik Fong, Rashad Abdul-Ghani, Arwa A. Ali, Fei-Wen Cheong, Rehab Tawfek, Rohela Mahmud

Abstract

Malaria is a public health threat in Yemen, with 149,451 cases being reported in 2013. Of these, Plasmodium falciparum represents 99 %. Prompt diagnosis by light microscopy (LM) and rapid diagnostic tests (RTDs) is a key element in the national strategy of malaria control. The heterogeneous epidemiology of malaria in the country necessitates the field evaluation of the current diagnostic strategies, especially RDTs. Thus, the present study aimed to evaluate LM and an RDT, combining both P. falciparum histidine-rich protein-2 (PfHRP-2) and Plasmodium lactate dehydrogenase (pLDH), for falciparum malaria diagnosis and survey in a malaria-endemic area during the transmission season against nested polymerase chain reaction (PCR) as the reference method. A household-based, cross-sectional malaria survey was conducted in Mawza District, a malaria-endemic area in Taiz governorate. A total of 488 participants were screened using LM and PfHRP-2/pLDH RDT. Positive samples (160) and randomly selected negative samples (52) by both RDT and LM were further analysed using 18S rRNA-based nested PCR. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the RDT were 96.0 % (95 % confidence interval (CI): 90.9-98.3), 56.0 % (95 % CI: 44.7-66.8), 76.3 % (95 % CI: 69.0-82.3), and 90.4 % (95 % CI: 78.8-96.8), respectively. On the other hand, LM showed sensitivity of 37.6 % (95 % CI: 29.6-46.3), specificity of 97.6 % (95 % CI: 91.7-99.7), PPV of 95.9 % (95 % CI: 86.3-98.9), and NPV of 51.3 % (95 % CI: 43.2-59.2). The sensitivity of LM dropped to 8.5 % for detecting asymptomatic malaria. Malaria prevalence was 32.8 % (32.1 and 37.5 % for ≥10 and <10 years, respectively) with the RDT compared with 10.7 % (10.8 and 9.4 % for age groups of ≥10 and <10 years, respectively) with LM. Among asymptomatic malaria individuals, LM and RDT-based prevalence rates were 1.6 and 25.6 %, respectively. However, rates of 88.2 and 94.1 % of infection with P. falciparum were found among patients who reported fever in the 48 h prior to the survey by LM and PfHRP-2/pLDH RDT, respectively. The PfHRP-2/pLDH RDT shows high sensitivity for the survey of falciparum malaria even for asymptomatic malaria cases. Although the RDT had high sensitivity, its high false-positivity rate limits its utility as a single diagnostic tool for clinical diagnosis of malaria. On the other hand, low sensitivity of LM indicates that a high proportion of malaria cases is missed, underestimating the true prevalence of malaria in the community. Higher NPV of PfHRP-2/pLDH RDT than LM can give a straightforward exclusion of malaria among febrile patients, helping to avoid unnecessary presumptive treatments.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 38 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 24%
Student > Ph. D. Student 7 18%
Researcher 4 11%
Lecturer 3 8%
Student > Bachelor 3 8%
Other 9 24%
Unknown 3 8%
Readers by discipline Count As %
Medicine and Dentistry 12 32%
Immunology and Microbiology 6 16%
Agricultural and Biological Sciences 6 16%
Nursing and Health Professions 4 11%
Biochemistry, Genetics and Molecular Biology 3 8%
Other 3 8%
Unknown 4 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 January 2016.
All research outputs
#6,665,740
of 9,183,951 outputs
Outputs from Malaria Journal
#2,553
of 3,186 outputs
Outputs of similar age
#216,969
of 340,616 outputs
Outputs of similar age from Malaria Journal
#149
of 197 outputs
Altmetric has tracked 9,183,951 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,186 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 340,616 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 197 others from the same source and published within six weeks on either side of this one. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.