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Performance of antigen concentration thresholds for attributing fever to malaria among outpatients in Angola

Plucinski, Mateusz M. and Rogier, Eric and Dimbu, Pedro Rafael and Fortes, Filomeno and Halsey, Eric S. and Aidoo, Michael and Smith, Tom. (2019) Performance of antigen concentration thresholds for attributing fever to malaria among outpatients in Angola. Journal of clinical microbiology, 57 (3). e01901-18.

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Official URL: https://edoc.unibas.ch/69740/

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Abstract

The density of malaria parasites is a key determinant of whether an infected individual develops fever. While the pyrogenic threshold for malaria parasite density has been well studied, there are no analogous data on the antigen levels associated with fever during infection. Samples from 797 afebrile and 457 febrile outpatients from two provinces in Angola with known concentrations of histidine-rich protein 2 (HRP2), aldolase, and lactate dehydrogenase (LDH) antigens were analyzed by Bayesian latent class modeling to attribute malarial etiology to the fevers and to estimate the sensitivity and specificity of different antigen thresholds for detection of malaria fevers. Among patients with aldolase or LDH levels detectable with a bead-based assay, the concentrations of these two antigens did not differ between afebrile and febrile patients. In contrast, the concentrations of HRP2 were substantially higher in febrile HRP2-positive patients than in afebrile HRP2-positive patients. When HRP2 concentrations were considered, the malaria-attributable fractions of fever cases were 0.092 in Huambo Province and 0.39 in Uíge Province. Diagnostic tests detecting HRP2 with limits of detection (LODs) in the range of 3,000 to 10,000 pg/µl would provide ideal sensitivity and specificity for determination of malarial etiology among febrile persons.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Infectious Disease Modelling > Infectious Disease Modelling (Smith)
UniBasel Contributors:Smith, Thomas A.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Society for Microbiology
ISSN:0095-1137
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:12 Mar 2019 12:51
Deposited On:12 Mar 2019 12:51

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