Evaluating Rapid Diagnostic Tests for Malaria in Afghanistan
Author Information
Author(s): Mikhail Amy F W, Leslie Toby J, Mayan Mohammad I, Zekria Rohullah, Mohammad Nader, Hasanzai Mohammad A, Safi Najibullah, Whitty Christopher J M, Rowland Mark
Primary Institution: London School of Hygiene & Tropical Medicine
Hypothesis
Can different rapid diagnostic tests accurately detect Plasmodium vivax infections in a clinical setting in Afghanistan?
Conclusion
The CareStart Pf/Pan test was found to be the most reliable for detecting P. vivax in Afghanistan, while the other tests showed limitations, especially at low parasitaemia.
Supporting Evidence
- The CareStart Pf/Pan test had the highest sensitivity at 98.6%.
- The evaporative cooler maintained temperatures below 30°C during the study.
- Invalid results were significantly reduced when tests were stored in the evaporative cooler.
- The study included a diverse patient demographic from multiple outpatient facilities.
- Room temperature storage led to a higher rate of invalid results for some tests.
- Low parasitaemia negatively impacted the sensitivity of the CareStart Pf/Pv test.
- All tests demonstrated 100% specificity for malaria detection.
- The study highlights the importance of appropriate storage conditions for rapid diagnostic tests.
Takeaway
This study tested three malaria tests to see which one works best in hot weather. The best test was the CareStart Pf/Pan, which was good at finding the malaria bug.
Methodology
Patients were tested with three rapid diagnostic tests for malaria, comparing results from tests stored at room temperature and in an evaporative cooling box.
Potential Biases
Potential bias from varying expertise among microscopists who determined patient eligibility based on slide positivity.
Limitations
The study primarily included P. vivax positive patients, limiting the ability to assess specificity and the performance of tests at very low parasitaemia.
Participant Demographics
Patients were recruited from outpatient facilities in Jalalabad, Afghanistan, with a significant portion being children under 10 years old.
Statistical Information
P-Value
p<0.0001
Confidence Interval
[92.7 - 97.5]
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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