ArticleMalaria journal2025
Refining malaria diagnosis in high-transmission areas: a dual-approach with rapid diagnostic tests (RDTs) and dbPCR-NALFIA.
Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Field and laboratory evaluation of Abbott-Bioline™ Malaria Ag Pf/Pv RDT performance in a high-transmission setting: contrasting results with a low-endemic area.Malaria journal · 2026Article
- C-reactive protein, white blood cell counts and sequential interpretation of PfHRP2/pLDH for antibiotic stewardship in children under 5 years of age.BMC infectious diseases · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalaria rapid diagnostic tests (RDTs) are an essential tool in managing febrile illnesses in endemic settings. However, persisting parasite antigen after treatment or spontaneous remission, which can be detected by histidine-rich protein 2 (HRP2)-based RDT or Plasmodium lactate dehydrogenase (pLDH)-based RDTs, could lead to misdiagnosis. To overcome the latter, a diagnostic approach combining sequential interpretation of two-step malaria RDTs incorporating two parasite antigens detecting PfHRP2 and pLDH coupled with a direct-on-blood mini PCR-nucleic acid lateral flow immunoassay (dbPCR-NALFIA) has been evaluated.
methodsFebrile patients visiting two rural health facilities in Burkina Faso were enrolled. For each participant, an HRP2-based RDT and blood slides for microscopy (gold standard) were performed. A capillary blood sample was also collected in an EDTA tube and transported to laboratory to perform the two-step malaria RDT detecting HRP2 and LDH, and dbPCR-NALFIA testing. Malaria diagnostic results were sequentially interpreted and reported as: (i) positive when pLDH line appears regardless of the HRP2 results (PfHRP2 + /pLDH + or PfHRP2-/pLDH +); (ii) negative when both lines are absent (PfHRP2-/pLDH-); and (iii) undetermined when only the HRP2 line appears (PfHRP2 + /pLDH-). Undetermined cases were subsequently confirmed by dbPCR-NALFIA test and reported as positive or negative. Malaria microscopy was used as reference test of conclusive diagnostic results (PfHRP2 + /pLDH + , PfHRP2-/pLDH + or PfHRP2-/pLDH-) and qPCR for undetermined cases (PfHRP2 + /pLDH-).
resultsOut of 438 blood samples analysed, 87.2% (382/438) of patients with conclusive sequential interpretation of HRP2 and pLDH did not need confirmative testing with dbPCR-NALFIA. The sensitivity and specificity of these conclusive results were 98.8% and 95.3%, respectively. Following confirmation of undetermined sequential interpretation with dbPCR-NALFIA, the sequential algorithm had a sensitivity of 97.9%, a specificity of 94.8%, a positive predictive value of 97.2%, and a negative predictive value of 96.1%. For single HRP2-based RDT, the sensitivity was 95.2%, the specificity 73.2%, the positive predictive value 85.1%, and the negative predictive value 90.4%.
conclusionsThe sequential algorithm of the two-step RDTs combined with dbPCR-NALFIA on inconclusive results enhances the diagnosis of malaria in febrile patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.