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Volume 11 Supplement 1

Challenges in malaria research

  • Poster presentation
  • Open Access

Specificity of malaria rapid diagnostic tests is affected by Trypanosoma brucei gambiense sleeping sickness

  • 1,
  • 1,
  • 2,
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  • 3,
  • 4,
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  • 2,
  • 5 and
  • 1, 5
Malaria Journal201211 (Suppl 1) :P64

  • Published:


  • Malaria
  • Plasmodium
  • Rapid Diagnostic Test
  • Democratic Republic
  • Trypanosoma


In endemic settings, diagnosis of malaria increasingly relies on the use of rapid diagnostic tests (RDTs) instead of microscopic examinations. False positivity of such RDTs is poorly documented, although it may be particularly relevant in infections for which the differential diagnosis includes malaria, such as sleeping sickness, a fatal but treatable disease caused by Trypanosoma brucei parasite subspecies. We therefore examined the effect of Trypanosoma brucei gambiense sleeping sickness on the specificity of malaria RDTs.

Materials and methods

Blood samples of 117 sleeping sickness patients and 117 matched non-sleeping sickness controls were prospectively collected in the Democratic Republic of the Congo. Reference malaria diagnosis was based on microscopy corrected by a four primer real-time PCR. Ten commonly used rapid diagnostic tests for malaria were evaluated including three two-band tests and seven three-band tests, based on the detection of Pf-HRP-2, Pf-pLDH and/or pan-pLDH antigens of Plasmodium.


Specificity of RDTs for diagnosis of malaria in controls was between 97.5 and 100% and was between 11.3 and 98.8% in sleeping sickness patients. For seven out of 10 RDTs, specificity was significantly lower in sleeping sickness patients compared to controls. Decreased specificity of malaria RDTs in sleeping sickness was mainly caused by false positivity of the pan-pLDH test lines, but also occurred frequently for the HRP-2 test lines.The Pf-pLDH test lines were not affected.


Specificity of some malaria RDTs in sleeping sickness is surprisingly low, and constitutes a considerable risk for misdiagnosis or delayed diagnosis of sleeping sickness.

Authors’ Affiliations

Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
lnstitut National de Recherche Biomédical, Kinshasa, Democratic Republic of the Congo
Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Kinshasa, Democratic Republic of the Congo
Programme National de Lutte contre le Paludisme (PNLP), Kinshasa, Democratic Republic of the Congo
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium


© Gillet et al; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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