The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • John E Williams
  • Matthew Cairns
  • Fanta Njie
  • Stephen Laryea Quaye
  • Timothy Awine
  • Abraham Oduro
  • Harry Tagbor
  • Kalifa Bojang
  • Magnussen, Pascal
  • Feiko O Ter Kuile
  • Arouna Woukeu
  • Paul Milligan
  • Daniel Chandramohan
  • Brian Greenwood
BACKGROUND: Intermittent screening and treatment in pregnancy (ISTp) is a potential strategy for the control of malaria during pregnancy. However, the frequency and consequences of malaria infections missed by a rapid diagnostic test (RDT) for malaria are a concern.METHODS: Primigravidae and secundigravidae who participated in the ISTp arm of a noninferiority trial in 4 West African countries were screened with an HRP2/pLDH RDT on enrollment and, in Ghana, at subsequent antenatal clinic (ANC) visits. Blood samples were examined subsequently by microscopy and by a polymerase chain reaction (PCR) assay.

RESULTS: The sensitivity of the RDT to detect peripheral blood infections confirmed by microscopy and/or PCR at enrollment ranged from 91% (95% confidence interval [CI], 88%, 94%) in Burkina Faso to 59% (95% CI, 48%, 70% in The Gambia. In Ghana, RDT sensitivity was 89% (95% CI, 85%, 92%), 83% (95% CI, 76%, 90%) and 77% (95% CI, 67%, 86%) at enrollment, second and third ANC visits respectively but only 49% (95% CI, 31%, 66%) at delivery. Screening at enrollment detected 56% of all infections detected throughout pregnancy. Seventy-five RDT negative PCR or microscopy positive infections were detected in 540 women; these were not associated with maternal anemia, placental malaria, or low birth weight.

CONCLUSIONS: The sensitivity of an RDT to detect malaria in primigravidae and secundigravidae was high at enrollment in 3 of 4 countries and, in Ghana, at subsequent ANC visits. In Ghana, RDT negative malaria infections were not associated with adverse birth outcomes but missed infections were uncommon.
TidsskriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Udgave nummer7
Sider (fra-til)837-844
Antal sider8
StatusUdgivet - 1 apr. 2016

Antal downloads er baseret på statistik fra Google Scholar og

Ingen data tilgængelig

ID: 160164675