Publication: Use of a rapid test to assess plasma Plasmodium falciparum HRP2 and guide management of severe febrile illness
Issued Date
2015
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Language
eng
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Mahidol University
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BioMed Central
Bibliographic Citation
Malaria Journal. Vol.14, (2015), 362
Suggested Citation
Ipsita Sinha, Nattwut Ekapirat, Dondorp, Arjen M., Woodrow, Charles J. Use of a rapid test to assess plasma Plasmodium falciparum HRP2 and guide management of severe febrile illness. Malaria Journal. Vol.14, (2015), 362. doi:10.1186/s12936-015-0900-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/3097
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Title
Use of a rapid test to assess plasma Plasmodium falciparum HRP2 and guide management of severe febrile illness
Abstract
Background: Plasma Plasmodium falciparum histidine-rich protein-2 (PfHRP2) is the most accurate biomarker
for severe malaria, but its measurement by ELISA has been considered too unwieldy to incorporate into clinical
management.
Methods: Plasma samples covering a wide range of PfHRP2 concentrations were applied to rapid diagnostic tests
(RDTs). RDTs were read by eye and digital capture, and PfHRP2 concentrations were measured via serial dilution with
results compared to ELISA readings.
Results: The Paracheck® brand showed the strongest correlation (r2 = 0.963) as well as the lowest inter-observer
variability (combined kappa across band intensities for three observers = 0.938). Plasma PfHRP2 measurement via
serial dilution showed minimal bias compared to ELISA and acceptable limits of agreement. Three different dilutions
of a well characterized set of admission samples from uncomplicated and severe malaria patients studied in a low
transmission setting gave an area under the receiver operator characteristic curve of 0.844 in terms of identifying
severe malaria.
Conclusions: These studies show that plasma PfHRP2 can be assessed via a single RDT, with application of a
plasma dilution of 1:5 or 1:10 providing useful diagnostic information to assist in patient management or clinical trial
inclusion.