Volume 11 Supplement 1

Challenges in malaria research

Open Access

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

  • Philippe Gillet1,
  • Jan Jacobs1,
  • Dieudonné Mumba Ngoyi2,
  • Albert Lukuka2,
  • Viktor Kande3,
  • Benjamin Atua4,
  • Johan Van Griensven1,
  • Jean-Jacques Muyembe2,
  • Philippe Büscher5 and
  • Veerle Leion1, 5
Malaria Journal201211(Suppl 1):P64

https://doi.org/10.1186/1475-2875-11-S1-P64

Published: 15 October 2012

Background

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.

Results

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.

Conclusions

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

(1)
Department of Clinical Sciences, Institute of Tropical Medicine
(2)
lnstitut National de Recherche Biomédical
(3)
Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA)
(4)
Programme National de Lutte contre le Paludisme (PNLP)
(5)
Department of Biomedical Sciences, Institute of Tropical Medicine

Copyright

© 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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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