Performance Evaluation of a Combination Plasmodium Dual-antigen CRP Rapid Diagnostic Test in Lambaréné, Gabon

Overview

Journal Infection

Date 2024 Aug 23

PMID 39177882

Authors

Ayodele Alabi

Fungai P Musangomunei

Fabrice Lotola-Mougeni

Juste C Bie-Ondo

Kristin Murphy

Paulin N Essone

Anita L Kabwende

Saidou Mahmoudou

Aurelien Mace

Victoria Harris

Michael Ramharter

Martin P Grobusch

Maria Yazdanbakhsh

B Leticia Fernandez-Carballo

Camille Escadafal

Peter G Kremsner

Sabine Dittrich

Selidji T Agnandji

Affiliations

Soon will be listed here.

Abstract

Purpose: The consequent use of malaria rapid diagnostic tests (RDTs) preceding a treatment decision has improved the global management of malaria. A combination RDT, including an inflammation marker to potentially guide antibiotic prescription, could improve the management of acute febrile illness (AFI).

Methods: We performed a prospective, cross-sectional study in Gabon evaluating the STANDARD Malaria/CRP DUO (S-DUO) RDT. Participants aged 2 to 17 years with fever at presentation and/or a history of fever < 7 days were enrolled. Expert microscopy, SD Bioline Malaria Ag P.f/Pan test for malaria detection, and NycoCard CRP device for CRP were used as comparators. AFI cases were classified on a spectrum encompassing bacterial vs. non-bacterial infection.

Results: 415 participants with AFI were enrolled. S-DUO RDT sensitivity and specificity for malaria detection vs. microscopy were 99·1% (95·2-100%) and 72·7% (64·3-80·1%); and for CRP detection (20 mg/L and above) 86·9% (80-92%) and 87% (79·2-92·7%), respectively. The difference in CRP levels between bacterial infection (mean = 41·2 mg/L) and other causes of fever, measured from our study population using the Nycocard device, was statistically significant (p < 0·01); CRP precision-recall AUC to distinguish bacterial infection class vs. non-bacterial classifications was 0·79.

Conclusion: S-DUO RDT is suitable for malaria detection in moderate-to-high malaria transmission settings such as in Lambaréné; however, a CRP band detection limit > 40 mg/L is more adequate for indication of antibiotic prescription for AFI cases in Gabon.

Citing Articles

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Boundenga L, Sima-Biyang Y, Longo-Pendy N, Bignoumba M, Mbou-Boutambe C, Moukagni-Mussadji C Sci Rep. 2024; 14(1):31977.

PMID: 39738526 PMC: 11686293. DOI: 10.1038/s41598-024-83487-0.

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