Assessing field performance of ultrasensitive rapid diagnostic tests for malaria: a systematic review and meta-analysis

Bibliographic Details
Title: Assessing field performance of ultrasensitive rapid diagnostic tests for malaria: a systematic review and meta-analysis
Authors: Celestin Danwang, Fati Kirakoya-Samadoulougou, Sekou Samadoulougou
Source: Malaria Journal, Vol 20, Iss 1, Pp 1-11 (2021)
Publisher Information: BMC, 2021.
Publication Year: 2021
Collection: LCC:Arctic medicine. Tropical medicine
LCC:Infectious and parasitic diseases
Subject Terms: Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
More Details: Abstract Background To overcome the limitations of conventional malaria rapid diagnostic tests (cRDTs) in diagnosing malaria in patients with low parasitaemia, ultrasensitive malaria rapid diagnostic tests (uRDTs) have recently been developed, with promising results under laboratory conditions. The current study is the first meta-analysis comparing the overall sensitivity, and specificity of newly developed ultrasensitive Plasmodium falciparum malaria RDT (Alere™ Ultra-sensitive Malaria Ag P. falciparum RDT) with the cRDT conducted in the same field conditions. Methods PubMed, EMBASE, Cochrane infectious diseases group specialized register, and African Journals Online (AJOL) were searched up to 20th April 2021. Studies with enough data to compute sensitivity and specificity of uRDT and cRDT were retrieved. A random-effect model for meta-analysis was used to obtain the pooled sensitivity and specificity. Results Overall, 15 data sets from 14 studies were included in the meta-analysis. The overall sensitivity of the Alere™ ultra-sensitive Malaria Ag P. falciparum RDT regardless of the reference test and the clinical presentation of participants, was 55.5% (95% confidence interval [CI]: 45.5; 65.0), while the sensitivity regardless of the reference test and the clinical presentation of participants, was 42.9% (95% CI: 31.5; 55.2) for the cRDT performed in the same field conditions. When PCR was used as reference test, the sensitivity of uRDT was 60.4% (95% CI: 50.8; 69.2), while the sensitivity was 49.4% (95% CI: 38.2; 60.6) for the cRDT. The pooled specificity of uRDT regardless of the reference test and the clinical presentation of participants was 98.6% (95% CI: 97.1; 99.4), and the pooled specificity of cRDT regardless of the reference test and the clinical presentation of participants was 99.3% (95% CI: 98.1; 99.7). When PCR was used as reference test the specificity of uRDT and cRDT was 97.5% (95% CI: 94.1; 98.9) and 98.2% (95% CI: 95.5; 99.3). Regardless of the reference test used, the sensitivity of Alere™ Ultra-sensitive Malaria Ag P. falciparum RDT in symptomatic patients was 72.1% (95%CI: 67.4; 76.4), while sensitivity of cRDT was 67.4% (95%CI: 57.6; 75.9). Conclusion Findings of the meta-analysis show that Alere™ Ultra-sensitive Malaria Ag P. falciparum RDT compared to cRDT performed in the same field conditions has higher sensitivity but lower specificity although the difference is not statistically significant.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1475-2875
Relation: https://doaj.org/toc/1475-2875
DOI: 10.1186/s12936-021-03783-2
Access URL: https://doaj.org/article/5b29621d168547e684ba1e65aaec2b34
Accession Number: edsdoj.5b29621d168547e684ba1e65aaec2b34
Database: Directory of Open Access Journals
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More Details
ISSN:14752875
DOI:10.1186/s12936-021-03783-2
Published in:Malaria Journal
Language:English