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Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon
BACKGROUND: In malaria endemic areas, infected blood donors serve as a source of infection to blood recipients, which may adversely affect their prognosis. This necessitates the proper screening of blood to be used for transfusion in these areas. The purpose of this study was to determine the preval...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537946/ https://www.ncbi.nlm.nih.gov/pubmed/28760158 http://dx.doi.org/10.1186/s40249-017-0314-2 |
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author | Kwenti, Tebit Emmanuel Njunda, Longdoh Anna Tsamul, Beltine Nsagha, Shey Dickson Assob, Nguedia Jules-Clement Tufon, Kukwah Anthony Meriki, Dilonga Henry Orock, Enow George |
author_facet | Kwenti, Tebit Emmanuel Njunda, Longdoh Anna Tsamul, Beltine Nsagha, Shey Dickson Assob, Nguedia Jules-Clement Tufon, Kukwah Anthony Meriki, Dilonga Henry Orock, Enow George |
author_sort | Kwenti, Tebit Emmanuel |
collection | PubMed |
description | BACKGROUND: In malaria endemic areas, infected blood donors serve as a source of infection to blood recipients, which may adversely affect their prognosis. This necessitates the proper screening of blood to be used for transfusion in these areas. The purpose of this study was to determine the prevalence of malaria parasitaemia in blood donors in Buea, Cameroon, and to evaluate the performance of a rapid diagnostic test (RDT), a malaria antibody enzyme-linked immunosorbent assay (ELISA), and a Plasmodium lactate dehydrogenase (pLDH) ELISA in the detection of asymptomatic malaria parasitaemia in the target population. METHODS: In a prospective study conducted between September 2015 and June 2016, 1 240 potential blood donors were enrolled. The donors were screened for malaria parasites using Giemsa microscopy (GM) and a RDT. A sub-sample of 184 samples, comprising 88 positive and 96 negative samples, were selected for the evaluation of the pLDH ELISA and the antibody ELISA. The chi-square test and correlation analysis were performed as part of the statistical analyses. The statistical significance cut-off was set at P < 0.05. RESULTS: The prevalence of malaria parasitaemia in this study was found to be 8.1% (95% CI: 6.6 – 9.7). The prevalence was not observed to be dependent on the age or sex of the participants. The RDT had a sensitivity (88.0%), specificity (99.1%), and negative predictive value (99.0%) higher than the ELISAs. The performance of the pLDH ELISA, which demonstrated the highest positive predictive value (91.6%), was generally comparable to the RDT. The sensitivity was lowest with the antibody ELISA (69.9%), which also demonstrated the highest false positive and false negative rates. The detection threshold for the pLDH (three parasites/μl) was lower compared to the RDT (50 – 60 parasites/μl). Non-significant positive correlations were observed between the parasite density and the pLDH titers and malaria antibody titers. CONCLUSIONS: Overall, the RDT and the pLDH ELISA demonstrated a perfectly correlated agreement with GM, meanwhile the antibody ELISA demonstrated a substantially correlated agreement with GM. The pLDH is therefore recommended for mass screening of blood (to detect malaria parasitaemia) for transfusions in the study area. However, where this is not feasible, an RDT will suffice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0314-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5537946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55379462017-08-04 Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon Kwenti, Tebit Emmanuel Njunda, Longdoh Anna Tsamul, Beltine Nsagha, Shey Dickson Assob, Nguedia Jules-Clement Tufon, Kukwah Anthony Meriki, Dilonga Henry Orock, Enow George Infect Dis Poverty Research Article BACKGROUND: In malaria endemic areas, infected blood donors serve as a source of infection to blood recipients, which may adversely affect their prognosis. This necessitates the proper screening of blood to be used for transfusion in these areas. The purpose of this study was to determine the prevalence of malaria parasitaemia in blood donors in Buea, Cameroon, and to evaluate the performance of a rapid diagnostic test (RDT), a malaria antibody enzyme-linked immunosorbent assay (ELISA), and a Plasmodium lactate dehydrogenase (pLDH) ELISA in the detection of asymptomatic malaria parasitaemia in the target population. METHODS: In a prospective study conducted between September 2015 and June 2016, 1 240 potential blood donors were enrolled. The donors were screened for malaria parasites using Giemsa microscopy (GM) and a RDT. A sub-sample of 184 samples, comprising 88 positive and 96 negative samples, were selected for the evaluation of the pLDH ELISA and the antibody ELISA. The chi-square test and correlation analysis were performed as part of the statistical analyses. The statistical significance cut-off was set at P < 0.05. RESULTS: The prevalence of malaria parasitaemia in this study was found to be 8.1% (95% CI: 6.6 – 9.7). The prevalence was not observed to be dependent on the age or sex of the participants. The RDT had a sensitivity (88.0%), specificity (99.1%), and negative predictive value (99.0%) higher than the ELISAs. The performance of the pLDH ELISA, which demonstrated the highest positive predictive value (91.6%), was generally comparable to the RDT. The sensitivity was lowest with the antibody ELISA (69.9%), which also demonstrated the highest false positive and false negative rates. The detection threshold for the pLDH (three parasites/μl) was lower compared to the RDT (50 – 60 parasites/μl). Non-significant positive correlations were observed between the parasite density and the pLDH titers and malaria antibody titers. CONCLUSIONS: Overall, the RDT and the pLDH ELISA demonstrated a perfectly correlated agreement with GM, meanwhile the antibody ELISA demonstrated a substantially correlated agreement with GM. The pLDH is therefore recommended for mass screening of blood (to detect malaria parasitaemia) for transfusions in the study area. However, where this is not feasible, an RDT will suffice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0314-2) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-01 /pmc/articles/PMC5537946/ /pubmed/28760158 http://dx.doi.org/10.1186/s40249-017-0314-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kwenti, Tebit Emmanuel Njunda, Longdoh Anna Tsamul, Beltine Nsagha, Shey Dickson Assob, Nguedia Jules-Clement Tufon, Kukwah Anthony Meriki, Dilonga Henry Orock, Enow George Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title | Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title_full | Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title_fullStr | Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title_full_unstemmed | Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title_short | Comparative evaluation of a rapid diagnostic test, an antibody ELISA, and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea, Cameroon |
title_sort | comparative evaluation of a rapid diagnostic test, an antibody elisa, and a pldh elisa in detecting asymptomatic malaria parasitaemia in blood donors in buea, cameroon |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537946/ https://www.ncbi.nlm.nih.gov/pubmed/28760158 http://dx.doi.org/10.1186/s40249-017-0314-2 |
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