Evidence map›Paper›PMID 30476111›Full record

ArticleThe Journal of infectious diseases2019

Diagnostic Performance of Conventional and Ultrasensitive Rapid Diagnostic Tests for Malaria in Febrile Outpatients in Tanzania.

Natalie E Hofmann, Clara Antunes Moniz, Aurel Holzschuh, Kristina Keitel, Noémie Boillat-Blanco, Frank Kagoro, Josephine Samaka, Zainab Mbarack, Xavier C Ding, Iveth J González and 3 more

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
7.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 58 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 2 countries.

Natalie E HofmannSwiss Tropical and Public Health Institute, Basel.
Clara Antunes MonizSwiss Tropical and Public Health Institute, Basel.
Aurel HolzschuhSwiss Tropical and Public Health Institute, Basel.
Kristina KeitelSwiss Tropical and Public Health Institute, Basel.
Noémie Boillat-BlancoSwiss Tropical and Public Health Institute, Basel.
Frank KagoroIfakara Health Institute, Dar es Salaam, Tanzania.
Josephine SamakaAmana Hospital, Dar es Salaam, Tanzania.
Zainab MbarackMwananyamala Hospital, Dar es Salaam, Tanzania.
Xavier C DingFIND, Geneva, Switzerland.
Iveth J GonzálezFIND, Geneva, Switzerland.
Blaise GentonSwiss Tropical and Public Health Institute, Basel.
Valérie D'AcremontSwiss Tropical and Public Health Institute, Basel.
Ingrid FelgerSwiss Tropical and Public Health Institute, Basel.
Swiss Tropical and Public Health Institute · CHUniversity of Basel · CHAga Khan Hospital Dar es Salaam · TZFoundation for Innovative New Diagnostics · CHIfakara Health Institute · TZUniversity of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA novel ultrasensitive malaria rapid diagnostic test (us-RDT) has been developed for improved active Plasmodium falciparum infection detection. The usefulness of this us-RDT in clinical diagnosis and fever management has not been evaluated.

methodsDiagnostic performance of us-RDT was compared retrospectively to that of conventional RDT (co-RDT) in 3000 children and 515 adults presenting with fever to Tanzanian outpatient clinics. The parasite density was measured by an ultrasensitive qPCR (us-qPCR), and the HRP2 concentration was measured by an enzyme-linked immunosorbent assay.

resultsus-RDT identified few additional P. falciparum-positive patients as compared to co-RDT (276 vs 265 parasite-positive patients detected), with only a marginally greater sensitivity (75% vs 73%), using us-qPCR as the gold standard (357 parasite-positive patients detected). The specificity of both RDTs was >99%. Five of 11 additional patients testing positive by us-RDT had negative results by us-qPCR. The HRP2 concentration was above the limit of detection for co-RDT (>3653 pg of HRP2 per mL of blood) in almost all infections (99% [236 of 239]) with a parasite density >100 parasites per µL of blood. At parasite densities <100 parasites/µL, the HRP2 concentration was above the limits of detection of us-RDT (>793 pg/mL) and co-RDT in 29 (25%) and 24 (20%) of 118 patients, respectively.

conclusionThere is neither an advantage nor a risk of using us-RDT, rather than co-RDT, for clinical malaria diagnosis. In febrile patients, only a small proportion of infections are characterized by a parasite density or an HRP2 concentration in the range where use of us-RDT would confer a meaningful advantage over co-RDT.

Indexed as

Reagent Kits, DiagnosticAdolescentAdultAgedAged, 80 and overAntigens, ProtozoanBiomarkersChild, PreschoolCross-Sectional StudiesFalse Negative ReactionsFalse Positive ReactionsFeverHumansInfantLimit of DetectionMalaria, FalciparumAntigens, ProtozoanBiomarkersHRP-2 antigen, Plasmodium falciparumProtozoan ProteinsReagent Kits, DiagnosticdiagnosisfeverHRP2MalariaPCRquantitativeRDTTanzaniaultrasensitive

Identifiers

PMID30476111
PMCPMC6467194
OpenAlexW2901617829

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.