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Purpose <p>Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy.</p> Methods <p>This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f<sup>®</sup> (<i>Pf</i>HRP2) alongside combined SD-Bioline malaria RDT P.f<sup>®</sup> (HRP2/pLDH) and light microscopy (LM) against <i>varATS</i> quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of <i>Pf</i>HRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401.</p> Results <p>Malaria proportion was 79.9% (795/995), 88.7% (883/995) and 73.6% (732/995) by <i>varATS</i> qPCR, <i>Pf</i>HRP2-based RDT and LM respectively. <i>Pf</i>HRP2-based RDT and the LM showed similar accuracy [85.3% (95%CI: 83.0-87.5) and 84.6% (95%CI: 82.2–86.8), respectively], but differed in specificity [41.5% (95%CI: 34.6–48.7) <i>versus</i> 77.5% (95%CI: 71.1–83.1), <i>p</i> &lt; 0.001]. Specificity of <i>Pf</i>HRP2-based RDT further declined during the high transmission season compared to the low [27.1% (95%CI: 19.0-36.6) <i>versus</i> 58.1% (95%CI: 47.4–68.2), <i>p</i> &lt; 0.001]. In the subgroup, <i>Pf</i>HRP2/pLDH-based RDT showed higher specificity than <i>Pf</i>HRP2-based RDT during both high [42.3% (95%CI: 28.7–56.8) <i>versus</i> 17.3% (95%CI: 8.2–30.3), <i>p</i> &lt; 0.001] and low transmission seasons [84.0% (95%CI: 63.9–95.5) <i>versus</i> 60.0% (95%CI: 38.7–78.9), <i>p</i> &lt; 0.001]. Moreover, LM substantially agreed with <i>Pf</i>HRP2/pLDH-based RDT (Kappa = 0.71), but moderately with <i>Pf</i>HRP2-based RDT (Kappa = 0.46).</p> Conclusion <p>Findings suggest revising of malaria RDT recommendations, promoting <i>Pf</i>HRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.</p>

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Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH Based Rapid Diagnostic Tests among Children Under Five Years of Age in a High Seasonal Malaria Transmission Area in Burkina Faso

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  • 发表日期：

    2025年6月11日

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  • Delwendé Florence Ouédraogo,
  • Hamtandi Magloire Natama,
  • Hermann Sorgho,
  • Sarah Bénédicte Kaboré,
  • Mwinessobaonfou Athanase Somé,
  • Aida Millogo,
  • Abdoul-Rahim Ouédraogo,
  • Pieter Guetens,
  • Johanna Helena Kattenberg,
  • Aly Savadogo,
  • Halidou Tinto,
  • Anna Rosanas-Urgell

摘要

Purpose

Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy.

Methods

This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f® (PfHRP2) alongside combined SD-Bioline malaria RDT P.f® (HRP2/pLDH) and light microscopy (LM) against varATS quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of PfHRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401.

Results

Malaria proportion was 79.9% (795/995), 88.7% (883/995) and 73.6% (732/995) by varATS qPCR, PfHRP2-based RDT and LM respectively. PfHRP2-based RDT and the LM showed similar accuracy [85.3% (95%CI: 83.0-87.5) and 84.6% (95%CI: 82.2–86.8), respectively], but differed in specificity [41.5% (95%CI: 34.6–48.7) versus 77.5% (95%CI: 71.1–83.1), p < 0.001]. Specificity of PfHRP2-based RDT further declined during the high transmission season compared to the low [27.1% (95%CI: 19.0-36.6) versus 58.1% (95%CI: 47.4–68.2), p < 0.001]. In the subgroup, PfHRP2/pLDH-based RDT showed higher specificity than PfHRP2-based RDT during both high [42.3% (95%CI: 28.7–56.8) versus 17.3% (95%CI: 8.2–30.3), p < 0.001] and low transmission seasons [84.0% (95%CI: 63.9–95.5) versus 60.0% (95%CI: 38.7–78.9), p < 0.001]. Moreover, LM substantially agreed with PfHRP2/pLDH-based RDT (Kappa = 0.71), but moderately with PfHRP2-based RDT (Kappa = 0.46).

Conclusion

Findings suggest revising of malaria RDT recommendations, promoting PfHRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.