Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso

DF Ouédraogo; HM Natama; H Sorgho; SB Kaboré; MA Somé; A Millogo; AR Ouédraogo; P Guetens; JH Kattenberg; A Savadogo; H Tinto; A Rosanas-Urgell

doi:10.1007/s11686-025-01070-7

Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso

DF Ouédraogo, HM Natama, H Sorgho, SB Kaboré, MA Somé, A Millogo, AR Ouédraogo, P Guetens, JH Kattenberg, A Savadogo, H Tinto, A Rosanas-Urgell

Malariology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

Purpose
Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy.

Methods
This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f® (PfHRP2) alongside combined SD-Bioline malaria RDT P.f® (HRP2/pLDH) and light microscopy (LM) against varATS quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of PfHRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401.

Results
Malaria proportion was 79.9% (795/995), 88.7% (883/995) and 73.6% (732/995) by varATS qPCR, PfHRP2-based RDT and LM respectively. PfHRP2-based RDT and the LM showed similar accuracy [85.3% (95%CI: 83.0-87.5) and 84.6% (95%CI: 82.2–86.8), respectively], but differed in specificity [41.5% (95%CI: 34.6–48.7) versus 77.5% (95%CI: 71.1–83.1), p < 0.001]. Specificity of PfHRP2-based RDT further declined during the high transmission season compared to the low [27.1% (95%CI: 19.0-36.6) versus 58.1% (95%CI: 47.4–68.2), p < 0.001]. In the subgroup, PfHRP2/pLDH-based RDT showed higher specificity than PfHRP2-based RDT during both high [42.3% (95%CI: 28.7–56.8) versus 17.3% (95%CI: 8.2–30.3), p < 0.001] and low transmission seasons [84.0% (95%CI: 63.9–95.5) versus 60.0% (95%CI: 38.7–78.9), p < 0.001]. Moreover, LM substantially agreed with PfHRP2/pLDH-based RDT (Kappa = 0.71), but moderately with PfHRP2-based RDT (Kappa = 0.46).

Conclusion
Findings suggest revising of malaria RDT recommendations, promoting PfHRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.

Original language	English
Article number	132
Journal	Acta Parasitologica
Volume	70
Issue number	3
Number of pages	10
ISSN	1230-2821
DOIs	https://doi.org/10.1007/s11686-025-01070-7
Publication status	Published - 11-Jun-2025

Keywords

Malaria Diagnosis
PfHRP2-based RDT
PfHRP2/pLDH-based RDT
Seasonal Malaria Chemoprevention
VarATS qPCR
Burkina Faso/epidemiology
Malaria, Falciparum/diagnosis
Plasmodium falciparum/genetics
Diagnostic Tests, Routine/methods
Humans
Child, Preschool
Infant
Male
Malaria/diagnosis
Protozoan Proteins/genetics
Rapid Diagnostic Tests
Sensitivity and Specificity
Female
Seasons
Antigens, Protozoan/genetics
Longitudinal Studies

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Cite this

Ouédraogo, DF., Natama, HM., Sorgho, H., Kaboré, SB., Somé, MA., Millogo, A., Ouédraogo, AR., Guetens, P., Kattenberg, JH., Savadogo, A., Tinto, H., & Rosanas-Urgell, A. (2025). Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso. Acta Parasitologica, 70(3), Article 132. https://doi.org/10.1007/s11686-025-01070-7

@article{54e6c675bae341a488dc62d556067ea4,

title = "Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso",

abstract = "Purpose Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy. Methods This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f{\textregistered} (PfHRP2) alongside combined SD-Bioline malaria RDT P.f{\textregistered} (HRP2/pLDH) and light microscopy (LM) against varATS quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of PfHRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401. Results Malaria proportion was 79.9\% (795/995), 88.7\% (883/995) and 73.6\% (732/995) by varATS qPCR, PfHRP2-based RDT and LM respectively. PfHRP2-based RDT and the LM showed similar accuracy [85.3\% (95\%CI: 83.0-87.5) and 84.6\% (95\%CI: 82.2–86.8), respectively], but differed in specificity [41.5\% (95\%CI: 34.6–48.7) versus 77.5\% (95\%CI: 71.1–83.1), p < 0.001]. Specificity of PfHRP2-based RDT further declined during the high transmission season compared to the low [27.1\% (95\%CI: 19.0-36.6) versus 58.1\% (95\%CI: 47.4–68.2), p < 0.001]. In the subgroup, PfHRP2/pLDH-based RDT showed higher specificity than PfHRP2-based RDT during both high [42.3\% (95\%CI: 28.7–56.8) versus 17.3\% (95\%CI: 8.2–30.3), p < 0.001] and low transmission seasons [84.0\% (95\%CI: 63.9–95.5) versus 60.0\% (95\%CI: 38.7–78.9), p < 0.001]. Moreover, LM substantially agreed with PfHRP2/pLDH-based RDT (Kappa = 0.71), but moderately with PfHRP2-based RDT (Kappa = 0.46). Conclusion Findings suggest revising of malaria RDT recommendations, promoting PfHRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.",

keywords = "Malaria Diagnosis, PfHRP2-based RDT, PfHRP2/pLDH-based RDT, Seasonal Malaria Chemoprevention, VarATS qPCR, Burkina Faso/epidemiology, Malaria, Falciparum/diagnosis, Plasmodium falciparum/genetics, Diagnostic Tests, Routine/methods, Humans, Child, Preschool, Infant, Male, Malaria/diagnosis, Protozoan Proteins/genetics, Rapid Diagnostic Tests, Sensitivity and Specificity, Female, Seasons, Antigens, Protozoan/genetics, Longitudinal Studies",

author = "DF Ou{\'e}draogo and HM Natama and H Sorgho and SB Kabor{\'e} and MA Som{\'e} and A Millogo and AR Ou{\'e}draogo and P Guetens and JH Kattenberg and A Savadogo and H Tinto and A Rosanas-Urgell",

note = "FTX; DOAJ; (CC BY-NC-ND) {\textcopyright} 2025. The Author(s).",

year = "2025",

month = jun,

day = "11",

doi = "10.1007/s11686-025-01070-7",

language = "English",

volume = "70",

journal = "Acta Parasitologica",

issn = "1230-2821",

publisher = "Walter de Gruyter GmbH",

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Ouédraogo, DF, Natama, HM, Sorgho, H, Kaboré, SB, Somé, MA, Millogo, A, Ouédraogo, AR, Guetens, P , Kattenberg, JH, Savadogo, A, Tinto, H & Rosanas-Urgell, A 2025, 'Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso', Acta Parasitologica, vol. 70, no. 3, 132. https://doi.org/10.1007/s11686-025-01070-7

Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso. / Ouédraogo, DF; Natama, HM; Sorgho, H et al.
In: Acta Parasitologica, Vol. 70, No. 3, 132, 11.06.2025.

Research output: Contribution to journal › A1: Web of Science-article › peer-review

TY - JOUR

T1 - Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso

AU - Ouédraogo, DF

AU - Natama, HM

AU - Sorgho, H

AU - Kaboré, SB

AU - Somé, MA

AU - Millogo, A

AU - Ouédraogo, AR

AU - Guetens, P

AU - Kattenberg, JH

AU - Savadogo, A

AU - Tinto, H

AU - Rosanas-Urgell, A

PY - 2025/6/11

Y1 - 2025/6/11

N2 - Purpose Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy. Methods This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f® (PfHRP2) alongside combined SD-Bioline malaria RDT P.f® (HRP2/pLDH) and light microscopy (LM) against varATS quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of PfHRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401. Results Malaria proportion was 79.9% (795/995), 88.7% (883/995) and 73.6% (732/995) by varATS qPCR, PfHRP2-based RDT and LM respectively. PfHRP2-based RDT and the LM showed similar accuracy [85.3% (95%CI: 83.0-87.5) and 84.6% (95%CI: 82.2–86.8), respectively], but differed in specificity [41.5% (95%CI: 34.6–48.7) versus 77.5% (95%CI: 71.1–83.1), p < 0.001]. Specificity of PfHRP2-based RDT further declined during the high transmission season compared to the low [27.1% (95%CI: 19.0-36.6) versus 58.1% (95%CI: 47.4–68.2), p < 0.001]. In the subgroup, PfHRP2/pLDH-based RDT showed higher specificity than PfHRP2-based RDT during both high [42.3% (95%CI: 28.7–56.8) versus 17.3% (95%CI: 8.2–30.3), p < 0.001] and low transmission seasons [84.0% (95%CI: 63.9–95.5) versus 60.0% (95%CI: 38.7–78.9), p < 0.001]. Moreover, LM substantially agreed with PfHRP2/pLDH-based RDT (Kappa = 0.71), but moderately with PfHRP2-based RDT (Kappa = 0.46). Conclusion Findings suggest revising of malaria RDT recommendations, promoting PfHRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.

AB - Purpose Despite countrywide seasonal malaria chemoprevention (SMC) in Burkina Faso, malaria remains high among under-five year children during peak transmission season, questioning about SMC effectiveness and diagnostic tools accuracy. Methods This study assessed the performance of SD-Bioline malaria rapid diagnostic test (RDT) P.f® (PfHRP2) alongside combined SD-Bioline malaria RDT P.f® (HRP2/pLDH) and light microscopy (LM) against varATS quantitative polymerase chain reaction (qPCR) as reference, among SMC-aged children in high seasonal malaria transmission setting in Burkina Faso. A two-year longitudinal study (March 2019-March 2021) conducted in Nanoro health district screened 995 suspected malaria cases. Diagnostic performances of PfHRP2-based RDT and LM were assessed in all cases, while both RDTs were evaluated in a subgroup of 401. Results Malaria proportion was 79.9% (795/995), 88.7% (883/995) and 73.6% (732/995) by varATS qPCR, PfHRP2-based RDT and LM respectively. PfHRP2-based RDT and the LM showed similar accuracy [85.3% (95%CI: 83.0-87.5) and 84.6% (95%CI: 82.2–86.8), respectively], but differed in specificity [41.5% (95%CI: 34.6–48.7) versus 77.5% (95%CI: 71.1–83.1), p < 0.001]. Specificity of PfHRP2-based RDT further declined during the high transmission season compared to the low [27.1% (95%CI: 19.0-36.6) versus 58.1% (95%CI: 47.4–68.2), p < 0.001]. In the subgroup, PfHRP2/pLDH-based RDT showed higher specificity than PfHRP2-based RDT during both high [42.3% (95%CI: 28.7–56.8) versus 17.3% (95%CI: 8.2–30.3), p < 0.001] and low transmission seasons [84.0% (95%CI: 63.9–95.5) versus 60.0% (95%CI: 38.7–78.9), p < 0.001]. Moreover, LM substantially agreed with PfHRP2/pLDH-based RDT (Kappa = 0.71), but moderately with PfHRP2-based RDT (Kappa = 0.46). Conclusion Findings suggest revising of malaria RDT recommendations, promoting PfHRP2/pLDH-based RDTs to improve malarial and non-malarial fevers management in SMC-aged children.

KW - Malaria Diagnosis

KW - PfHRP2-based RDT

KW - PfHRP2/pLDH-based RDT

KW - Seasonal Malaria Chemoprevention

KW - VarATS qPCR

KW - Burkina Faso/epidemiology

KW - Malaria, Falciparum/diagnosis

KW - Plasmodium falciparum/genetics

KW - Diagnostic Tests, Routine/methods

KW - Humans

KW - Child, Preschool

KW - Infant

KW - Male

KW - Malaria/diagnosis

KW - Protozoan Proteins/genetics

KW - Rapid Diagnostic Tests

KW - Sensitivity and Specificity

KW - Female

KW - Seasons

KW - Antigens, Protozoan/genetics

KW - Longitudinal Studies

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U2 - 10.1007/s11686-025-01070-7

DO - 10.1007/s11686-025-01070-7

M3 - A1: Web of Science-article

C2 - 40498130

SN - 1230-2821

VL - 70

JO - Acta Parasitologica

JF - Acta Parasitologica

IS - 3

M1 - 132

ER -

Performances of Malaria PfHRP2 and the Combined PfHRP2/pLDH based rapid diagnostic tests among children under five years of age in a high seasonal malaria transmission area in Burkina Faso

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