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Malaria rapid diagnostic tests: Plasmodium falciparum infections with high parasite densities may generate false positive Plasmodium vivax pLDH lines

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dc.contributor.author Maltha, J.
dc.contributor.author Gillet, P.
dc.contributor.author Cnops, L.
dc.contributor.author Van den Ende, J.
dc.contributor.author Van Esbroeck, M.
dc.contributor.author Jacobs, J.
dc.date.accessioned 2010-08-17T12:21:43Z
dc.date.available 2010-08-17T12:21:43Z
dc.date.issued 2010
dc.identifier.issn 1475-2875
dc.identifier.doi http://dx.doi.org/10.1186/1475-2875-9-198
dc.identifier.other ITG-C2A
dc.identifier.other ITG-C3B
dc.identifier.other ITG-C4A
dc.identifier.other ITG-C5A
dc.identifier.other ITG-CLA
dc.identifier.other CLINIC
dc.identifier.other U-CLIBIO
dc.identifier.other U-TROPIC
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other URL
dc.identifier.other FTA
dc.identifier.other Electronic
dc.identifier.other UPD24
dc.identifier.uri http://hdl.handle.net/10390/6244
dc.description.abstract BACKGROUND: Most malaria rapid diagnostic tests (RDTs) detect Plasmodium falciparum and an antigen common to the four species. Plasmodium vivax-specific RDTs target P. vivax-specific parasite lactate dehydrogenase (Pv-pLDH). Previous observations of false positive Pv-pLDH test lines in P. falciparum samples incited to the present study, which assessed P. vivax-specific RDTs for the occurrence of false positive Pv-pLDH lines in P. falciparum samples. METHODS: Nine P. vivax-specific RDTs were tested with 85 P. falciparum samples of high (>/=2%) parasite density. Mixed P. falciparum/P. vivax infections were ruled out by real-time PCR. The RDTs included two-band (detecting Pv-pLDH), three-band (detecting P. falciparum-antigen and Pv-pLDH) and four-band RDTs (detecting P. falciparum, Pv-pLDH and pan-pLDH). RESULTS: False positive Pv-pLDH lines were observed in 6/9 RDTs (including two- three- and four-band RDTs). They occurred in the individual RDT brands at frequencies ranging from 8.2% to 29.1%. For 19/85 samples, at least two RDT brands generated a false positive Pv-pLDH line. Sixteen of 85 (18.8%) false positive lines were of medium or strong line intensity. There was no significant relation between false positive results and parasite density or geographic origin of the samples. CONCLUSION: False positive Pv-pLDH lines in P. falciparum samples with high parasite density occurred in 6/9 P. vivax-specific RDTs. This is of concern as P. falciparum and P. vivax are co-circulating in many regions. The diagnosis of life-threatening P. falciparum malaria may be missed (two-band Pv-pLDH RDT), or the patient may be treated incorrectly with primaquine (three- or four-band RDTs) en
dc.language English en
dc.subject Protozoal diseases en
dc.subject Malaria en
dc.subject Plasmodium falciparum en
dc.subject Plasmodium vivax en
dc.subject Vectors en
dc.subject Mosquitoes en
dc.subject Diagnostics en
dc.subject Rapid diagnostic tests en
dc.subject False-positive en
dc.subject Parasite density en
dc.subject Accuracy en
dc.subject Laboratory techniques and procedures en
dc.title Malaria rapid diagnostic tests: Plasmodium falciparum infections with high parasite densities may generate false positive Plasmodium vivax pLDH lines en
dc.type Article-E en
dc.citation.issue 198 en
dc.citation.jtitle Malaria Journal en
dc.citation.volume 9 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/20618990
dc.identifier.url http://www.malariajournal.com/content/9/1/198
dc.citation.jabbreviation Malar J en


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