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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/109604
Analytical sensitivity of current best-in-class malaria rapid diagnostic tests
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BACKGROUND: Rapid diagnostic tests (RDTs) are today the most
widely used method for malaria diagnosis and are recommended,
alongside microscopy, for the confirmation of suspected cases
before the administration of anti-malarial treatment. The
diagnostic performance of RDTs, as compared to microscopy or PCR
is well described but the actual analytical sensitivity of
current best-in-class tests is poorly documented. This value is
however a key performance indicator and a benchmark value needed
to developed new RDTs of improved sensitivity. METHODS: Thirteen
RDTs detecting either the Plasmodium falciparum histidine rich
protein 2 (HRP2) or the plasmodial lactate dehydrogenase (pLDH)
antigens were selected from the best performing RDTs according
to the WHO-FIND product testing programme. The analytical
sensitivity of these products was evaluated using a range of
reference materials including P. falciparum and Plasmodium vivax
whole parasite samples as well as recombinant proteins. RESULTS:
The best performing HRP2-based RDTs could detect all P.
falciparum cultured samples at concentrations as low as 0.8
ng/mL of HRP2. The limit of detection of the best performing
pLDH-based RDT specifically detecting P. vivax was 25 ng/mL of
pLDH. CONCLUSION: The analytical sensitivity of P. vivax and Pan
pLDH-based RDTs appears to vary considerably from product to
product, and improvement of the limit-of-detection for P. vivax
detecting RDTs is needed to match the performance of HRP2 and Pf
pLDH-based RDTs for P. falciparum. Different assays using
different reference materials produce different values for
antigen concentration in a given specimen, highlighting the need
to establish universal reference assays.
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JIMÉNEZ, Alfons, et al. Analytical sensitivity of current best-in-class malaria rapid
diagnostic tests. Malaria Journal. 2017. Vol. 16, num. 128. ISSN 1475-2875. [consulted: 11 of June of 2026]. Available at: https://hdl.handle.net/2445/109604