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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Prozone in malaria rapid diagnostics tests: How many cases are missed?
Malaria Journal, Volume 10, Article 166, Year 2011
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Description
Background: Prozone means false-negative or false-low results in antigen-antibody reactions, due to an excess of either antigen or antibody. The present study prospectively assessed its frequency for malaria rapid diagnostic tests (RDTs) and Plasmodium falciparum samples in an endemic field setting. Methods. From January to April 2010, blood samples with P. falciparum high parasitaemia ( 4% red blood cells infected) were obtained from patients presenting at the Provincial Hospital of Tete (Mozambique). Samples were tested undiluted and 10-fold diluted in saline with a panel of RDTs and results were scored for line intensity (no line visible, faint, weak, medium and strong). Prozone was defined as a sample which showed no visible test line or a faint or weak test line when tested undiluted, and a visible test line of higher intensity when tested 10-fold diluted, as observed by two blinded observers and upon duplicate testing. Results: A total of 873/7,543 (11.6%) samples showed P. falciparum, 92 (10.5%) had high parasitaemia and 76 were available for prozone testing. None of the two Pf-pLDH RDTs, but all six HRP-2 RDTs showed prozone, at frequencies between 6.7% and 38.2%. Negative and faint HRP-2 lines accounted for four (3.8%) and 15 (14.4%) of the 104 prozone results in two RDT brands. For the most affected brand, the proportions of prozone with no visible or faint HRP-2 lines were 10.9% (CI: 5.34-19.08), 1.2% (CI: 0.55-2.10) and 0.1% (CI: 0.06-0.24) among samples with high parasitaemia, all positive samples and all submitted samples respectively. Prozone occurred mainly, but not exclusively, among young children. Conclusion: Prozone occurs at different frequency and intensity in HRP-2 RDTs and may decrease diagnostic accuracy in the most affected RDTs. © 2011 Gillet et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Gillet, Philippe
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Scheirlinck, Annelies
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Stokx, Jocelijn
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
De Weggheleire, Anja
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Chaúque, Hélder S.
Unknown Affiliation
Canhanga, Oreana Djv
Unknown Affiliation
Tadeu, Benvindo Toni Maria
Unknown Affiliation
Mosse, Carla Dd
Unknown Affiliation
Tiago, Armindo
Mozambique, Maputo
National Malaria Control Programme
Mabunda, Samuel Jose Alves
Mozambique, Maputo
National Malaria Control Programme
Bruggeman, Cathrien Alberta M.V.A.
Netherlands, Maastricht
Universiteit Maastricht
Bottieau, Emmanuel
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Jacobs, Jan Adriaan
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Statistics
Citations: 98
Authors: 13
Affiliations: 4
Identifiers
Doi:
10.1186/1475-2875-10-166
e-ISSN:
14752875
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Locations
Mozambique