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Performance of an algorithm including RDT and fluorescence microscopy for the diagnosis of malaria in highly endemic areas

  • 2012/06/05
  • 2014/06/05
Chef de projet
  • Yap Boum
  • Ouganda
  • Paludisme
The use of malaria RDT improves patient management, by providing a prompt laboratory–based diagnosis of malaria. RDTs performance in field conditions however are far to be as good as demonstrated in the evaluation program of WHO and FIND. In particular the high proportion of false positive results of HRP2-based RDTs in high transmission settings is of concern. This seems to be due to the long time to clearance of the HRP2 antigen.
We think we can overcome this concern by coupling RDT with microscopy fluorescence. Fluorescence microscopy is a rather simple technique, though more complicated than RDT. A drop of patient’s blood is put on a slide already coated with a DNA fluorescence marker. The slide can be read within a few minutes.
The primary objective if this study is to evaluate the performance of the following diagnostic algorithm.Patients with fever will be investigated on recent episode of malaria; patient with a recent episode of malaria will have fluorescence microscopy test. Patients with no recent episode of malaria will have an RDT.This algorithm is expected to be as sensitive as and more specific than RDT, with a minimum extra cost related to the use of fluorescence microscopy in a subgroup of patients.