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Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy
BACKGROUND: Achieving malaria elimination requires the targeting of the human reservoir of infection, including those patients with asymptomatic infection. The objective was to synthesise evidence on the accuracy of the rapid-onsite diagnostic tests (RDTs) and microscopy for the detection of asympto...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848787/ https://www.ncbi.nlm.nih.gov/pubmed/35172833 http://dx.doi.org/10.1186/s12936-022-04082-0 |
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author | Naing, Cho Htet, Norah Htet Aye, Saint Nway Aung, Htar Htar Tanner, Marcel Whittaker, Maxine A. |
author_facet | Naing, Cho Htet, Norah Htet Aye, Saint Nway Aung, Htar Htar Tanner, Marcel Whittaker, Maxine A. |
author_sort | Naing, Cho |
collection | PubMed |
description | BACKGROUND: Achieving malaria elimination requires the targeting of the human reservoir of infection, including those patients with asymptomatic infection. The objective was to synthesise evidence on the accuracy of the rapid-onsite diagnostic tests (RDTs) and microscopy for the detection of asymptomatic malaria as part of the surveillance activities in Asian countries. METHODS: This was a meta-analysis of diagnostic test accuracy. Relevant studies that evaluated the diagnostic performance of RDTs and microscopy for detection of asymptomatic malaria were searched in health-related electronic databases. The methodological quality of the studies included was assessed using the QUADAS-2 tool. RESULTS: Ten studies assessing RDT and/or microscopy were identified. The diagnostic accuracies in all these studies were verified by PCR. Overall, the pooled sensitivities of RDT, as well as microscopy for detection of any malaria parasites in asymptomatic participants, were low, while their pooled specificities were almost ideal. For the detection of Plasmodium falciparum, pooled sensitivity by RDT (59%, 95%CI:16–91%) or microscopy (55%, 95%CI: 25–82%) were almost comparable. For detection of Plasmodium vivax, pooled sensitivity of RDT (51%, 95% CI:7–94%) had also the comparable accuracy of microscopy (54%, 95%CI,11–92%). Of note are the wide range of sensitivity and specificity. CONCLUSION: The findings of this meta-analysis suggest that RDTs and microscopy have limited sensitivity and are inappropriate for the detection of asymptomatic Plasmodium infections. Other methods including a combination of PCR-based strategies, Loop-Mediated Isothermal Amplification (LAMP) technique must be considered to target these infections, in order to achieve malaria elimination. However, more data is needed for the wide acceptance and feasibility of these approaches. Studies to explore the role of asymptomatic and sub-patent infections in the transmission of malaria are of critical importance and are recommended. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-022-04082-0. |
format | Online Article Text |
id | pubmed-8848787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88487872022-02-18 Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy Naing, Cho Htet, Norah Htet Aye, Saint Nway Aung, Htar Htar Tanner, Marcel Whittaker, Maxine A. Malar J Research BACKGROUND: Achieving malaria elimination requires the targeting of the human reservoir of infection, including those patients with asymptomatic infection. The objective was to synthesise evidence on the accuracy of the rapid-onsite diagnostic tests (RDTs) and microscopy for the detection of asymptomatic malaria as part of the surveillance activities in Asian countries. METHODS: This was a meta-analysis of diagnostic test accuracy. Relevant studies that evaluated the diagnostic performance of RDTs and microscopy for detection of asymptomatic malaria were searched in health-related electronic databases. The methodological quality of the studies included was assessed using the QUADAS-2 tool. RESULTS: Ten studies assessing RDT and/or microscopy were identified. The diagnostic accuracies in all these studies were verified by PCR. Overall, the pooled sensitivities of RDT, as well as microscopy for detection of any malaria parasites in asymptomatic participants, were low, while their pooled specificities were almost ideal. For the detection of Plasmodium falciparum, pooled sensitivity by RDT (59%, 95%CI:16–91%) or microscopy (55%, 95%CI: 25–82%) were almost comparable. For detection of Plasmodium vivax, pooled sensitivity of RDT (51%, 95% CI:7–94%) had also the comparable accuracy of microscopy (54%, 95%CI,11–92%). Of note are the wide range of sensitivity and specificity. CONCLUSION: The findings of this meta-analysis suggest that RDTs and microscopy have limited sensitivity and are inappropriate for the detection of asymptomatic Plasmodium infections. Other methods including a combination of PCR-based strategies, Loop-Mediated Isothermal Amplification (LAMP) technique must be considered to target these infections, in order to achieve malaria elimination. However, more data is needed for the wide acceptance and feasibility of these approaches. Studies to explore the role of asymptomatic and sub-patent infections in the transmission of malaria are of critical importance and are recommended. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-022-04082-0. BioMed Central 2022-02-16 /pmc/articles/PMC8848787/ /pubmed/35172833 http://dx.doi.org/10.1186/s12936-022-04082-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Naing, Cho Htet, Norah Htet Aye, Saint Nway Aung, Htar Htar Tanner, Marcel Whittaker, Maxine A. Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title | Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title_full | Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title_fullStr | Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title_full_unstemmed | Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title_short | Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy |
title_sort | detection of asymptomatic malaria in asian countries: a meta-analysis of diagnostic accuracy |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848787/ https://www.ncbi.nlm.nih.gov/pubmed/35172833 http://dx.doi.org/10.1186/s12936-022-04082-0 |
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