0 43.3% (33.0–54.2) ≥10,000 21 21 0 100 Overall 80 64 16 94.0 In terms of proficiency, at the first step, which was also a selection test, 13 of the 15 CHWs who were trained were classified as competent to perform the RDT test. The two others classified as “in training” were retrained, but did not take part in the study. At the second step, all the CHWs were able to adequately implement the trial-required procedures. Discussion During this trial, the authors evaluated the performance of this HRP-2-based
RDT used by trained CHWs under field conditions. A limit www.selleckchem.com/products/ABT-263.html of this trial is the absence of data on the quality of the RDTs in the field to document that this quality has not biased the results that was obtained. However, we do not think that the quality of RDT was altered in the field. selleck The stability under heat conditions is the main concern for RDTs and, as mentioned in “Methods”, the RDT tests were kept under temperature-controlled conditions in the research center pharmacy store and the CHWs received weekly supply. Also, during the dry season when the temperature in the field is extremely high (up to 40 °C), the test has proved to
still have a high sensitivity and specificity profile as compared to that recorded during the rainy season where risk of exposure to extreme heat is minor. The overall sensitivity of the RDT was high when compared with light microscopy in terms of detecting individuals infected by P. falciparum. This confirms what has been reported in other studies [19–21]. RDTs can be useful and reliable tools in the management of patients with suspected malaria, especially in contexts where microscopic diagnosis is not readily available, such as in remote area health centers or in the context of community case management of malaria, in which treatment is provided by trained volunteers from the community. The sensitivity
of the RDT has remained high across malaria transmission seasons and age range except in children aged between 48 and 59 months where Cell press a reduced sensitivity below acceptable threshold for RDTs was observed when the parasite count was low (below 500). It has been shown that HRP-2 tests could fail to Osimertinib in vivo detect low-level parasite densities [22–25]. However, the test also failed to detect two cases of P. falciparum infection with high parasite count in the same age group. A possible reason is that age-dependent immune status can reduce HRP-2 sensitivity independently of parasite density . This hypothesis is highly plausible in the context of intense and marked seasonal malaria transmission where individuals will acquire semi immune protection against malaria early in life . Another possible reason is that HRP-2 test sensitivity can be affected by the variability of HRP-2, the target antigen in specific settings . This might not be the case in this context since the study was conducted in the same geographical area and polymorphism of the antigen was unlikely to occur.