False positive circumsporozoite protein ELISA: a challenge for the estimation of the entomological inoculation rate of malaria and for vector incrimination
2011

False Positives in Malaria Testing

Sample size: 16160 publication 10 minutes Evidence: high

Author Information

Author(s): Durnez Lies, Van Bortel Wim, Denis Leen, Roelants Patricia, Veracx Aurélie, Trung Ho Dinh, Sochantha Tho, Coosemans Marc

Primary Institution: Institute of Tropical Medicine, Department of Parasitology, Belgium

Hypothesis

The study aims to estimate the level of false positivity among different anopheline species in Cambodia and Vietnam and to check for the presence of other parasites that might interact with the anti-CSP monoclonal antibodies.

Conclusion

The CSP-ELISA can considerably overestimate the entomological inoculation rate, particularly for P. falciparum and for zoophilic species.

Supporting Evidence

  • 88% of mosquitoes positive for P. falciparum CSP-ELISA were confirmed negative by PCR.
  • False positive results were associated with zoophilic mosquito species.
  • The heat-unstable cross-reacting antigen was mainly present in the head and thorax of false positive specimens.

Takeaway

Sometimes tests for malaria can say a mosquito is infected when it's not, especially if the mosquito usually bites animals instead of people.

Methodology

Mosquitoes were collected in Cambodia and Vietnam, tested for sporozoites using CSP-ELISA, and confirmed by Plasmodium specific PCR.

Potential Biases

False positives were mainly observed in zoophilic mosquito species.

Limitations

The study did not identify the source of the cross-reacting antigen causing false positives.

Participant Demographics

Mosquitoes collected from various regions in Cambodia and Vietnam.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1475-2875-10-195

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