Detection of Malaria Parasite Protein in Urine of Patients with Acute Uncomplicated Malaria Using Rapid Diagnostic Test Kits

Year 2022, Volume: 12 Issue: 03, 97 - 107, 17.09.2022

Amusan Abiodun Akinola Olugbenga Akano Kazeem Gbotosho Grace Olusola

https://doi.org/10.5799/jmid.1176524

Cited By: 1

Abstract

Objectives: The invasive nature of the current malaria diagnostic techniques impairs compliance to diagnosis, especially for on-field detection. Adapting non-invasive methods of biological sample collection for rapid diagnosis of malaria infections may provide a more efficient approach to case management and epidemiological studies of malaria. This study was designed to evaluate the detection of Plasmodium falciparum Histidine-rich Protein II (PfHRP-2) in urine samples and optimization as diagnostic markers for P. falciparum infection.
Methods: One hundred (100) microscopically confirmed patients with Plasmodium falciparum infection and 25 P. falciparum negative controls were recruited for the study. Blood samples of all participants were tested for the presence of PfHRP-2 using Rapid Diagnostic Test (RDT) kits. In addition, urine samples of the confirmed malaria-infected patients were analyzed for PfHRP-2 using the CareStartTM and Global Devices (USA) Malaria kits. The diagnostic performances of the RDT kits were evaluated.
Results: Overall, the two brands of malaria rapid diagnostics demonstrated 71% sensitivity (95%CI=62.1-79.9%) and 96% specificity (95%CI=88.3-103.7%) for PfHRP-2 detection in urine.
The sensitivities of the tests in urine at asexual parasitemia ≤ 2000 μL-1 and asexual parasitemia > 2000 μL-1 were 69.6% (95%CI=56.3-82.9%) and 72.2% (95%CI=60.3-84.2%) respectively. Global Devices and CareStartTM kits had individual sensitivities of 80% (95%CI= 65.7-94.3%) and 67.1% (95%CI= 56.1-78.1%) respectively for PfHRP-2 detection in urine (P= 0.072).
Conclusion: Findings revealed that urine-based RDTs have limited capacities for malaria diagnosis due to their low sensitivity and require more optimizations to meet required diagnostic standards. J Microbiol Infect Dis 2022; 12(3):97-107.

Keywords

Rapid Diagnostic Test (RDT), non-invasive technique, Plasmodium falciparum Histidine-rich protein II (PfHRP-2), urine, sensitivity

References

• 1. World Health Organization. World Malaria Report. 2019. Retrieved from https://www.who.int/publications/i/item/9789240015791. Accessed 20 July 2021.
• 2. World Health Organization. World Malaria Report. 2021. Retrieved from https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2021. Accessed 1 March 2022.
• 3. World Health Organization. Global technical Strategy for malaria. 2016-2030. 2015. Retrieved from https://www.who.int/docs/default-source/documents/global-technical-strategy-for-malaria-2016-2030.pdf?sfvrsn=c82afcc_0. Accessed 22 July 2021.
• 4. World Health Organization. Guidelines for the treatment of malaria. 2020. Geneva. Switzerland. https://www.paho.org/en/node/50095. Accessed 22 July 2021.
• 5. Msellem MI, Martensson A, Rotllant G, et al. Influence of Rapid Malaria Diagnostic Tests on Treatment and Health Outcome in Fever Patients, Zanzibar-A Crossover Validation Study. PLoS Med 2009;6(4): e1000070. doi:10.1371/journal. pmed.1000070.
• 6. Tangpukdee N, Duangdee C, Wilairatana P, et al. Malaria Diagnosis: A Brief Review. Korean J Parasitol 2009; vol. 47, No. 2: 93-102.
• 7. Dzakah EE, Kang K, Ni C, et al. Comparative performance of aldolase and lactate dehydrogenase rapid diagnostic tests in Plasmodium vivax detection. Malar J 2014; 13:272.
• 8. World Health Organization. World malaria report. 1999. Retrieved from https://apps.who.int/iris/handle/10665/66321. Accessed 22 July 2021.
• 9. Nantavisai K. Malaria detection using non-blood samples. Songklanakarin J Sci Technol 2014;633-641.
• 10. Mouatcho JC and Goldring JPD. Malaria rapid diagnostic tests: challenges and prospects. J Med Microbiol 2013;62, 1491–1505 1491–1505.
• 11. Hutin YJ, Hauri AM, Armstrong GL. Use of injections in healthcare settings worldwide: literature review and regional estimates. BMJ 2003;327: 1075.
• 12. Wilson NO, Adjei AA, Anderson W, et al. Short Report: Detection of Plasmodium falciparum Histidine-rich Protein II in Saliva of Malaria Patients. Am J Trop Med Hyg 2008;78(5), pp. 733–735.
• 13. Hussein MIH, Albashir AAD, Elawad OAM et al. Malaria and COVID-19: Unmasking their ties. Malar J 2020; 19:457
• 14. Houze' S, Boly MD, Bras JL, et al. PfHRP-2 and PfLDH antigen detection for monitoring the efficacy of artemisinin-based combination therapy (ACT) in the treatment of uncomplicated falciparum malaria. Malar J 2009; 8:211.
• 15. Gbotosho GO, Happi CT, Folarin O, et al. Rapid detection of lactate dehydrogenase and genotyping of Plasmodium falciparum in saliva of children with acute uncomplicated malaria. Am J Trop Med Hyg 2010; 83, 496-501.
• 16. Nwakanma DC, Gomez-Escobar N, Walther M, et al. Quantitative Detection of Plasmodium falciparum DNA in Saliva, Blood, and Urine. JID 2009; 199: 1567–1574.
• 17. Oguonu T, Shu E, Ezeonwu BU, et al. The performance evaluation of a urine malaria test (UMT) kit for the diagnosis of malaria in individuals with fever in south-east Nigeria: cross-sectional analytical study. Malar J 2014; 13:403.
• 18. Oyibo WA, Ezeigwe N, Ntadom G, et al. Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria. J Clin Microbiol 2016; 55 (1):.
• 19. Anchinmane VT, Shedge RT. Detection of malarial parasite in urine of malaria patients: a future diagnostic approach. Int J Res Med Sci 2016;4(5):1702-1705.
• 20. Sheyin Z, Bigwan IE. Comparison of CareStart HRP-2 rapid malaria test with light microscopy for guiding patients' treatment of fever in Nigerian endemic areas. J Med Med Sci 2013; vol.4(9) pp. 353-356.
• 21. Markakpo US, Bosompem KM, Dzodzomenyo M, et al. Minimizing invasiveness in diagnostics: developing a rapid urine-based monoclonal antibody dipstick test for malaria. Trop Med Int Health 2016;21(10): 1263-1271. 22. Bell D, Peeling RW. Evaluation of rapid diagnostic tests: malaria. Nat Rev Microbiol 2006: S34 – S38.
• 23. Gatton ML, Chaudhry A, Glenn J, et al. Impact of Plasmodium falciparum gene deletions on malaria rapid diagnostic test performance. Malar J 2020; 19:392.
• 25. Castillo P, Mene'ndez C, Mayor A, et al. Massive Plasmodium falciparum visceral sequestration: a cause of maternal death in Africa. Clin Microbiol Infect 2013; 19: 1035–1041.
• 26. Sowunmi A, Akano K, Adejumo I, et al. Early rising asexual parasitemia in Nigerian children following a first dose of artemisinin-based combination treatments of falciparum malaria. BMC Infect Dis 2017; 17:110.
• 27. Silachamroon U, Phumratanaprapin W, Krudsood S, et al. Frequency of early rising parasitemia in falciparum malaria treated with artemisinin derivatives. Southeast Asian J Trop Med Public Health 2001;32(1):50-56.
• 28. Jafari S, Bras JL, Bouchaud O, et al. Plasmodium falciparum clinical population dynamics during malaria treatment. JID 2004; pp 195-203.
• 29. Thomas CE, Sexton W, Benson K, et al. Urine collection and processing for protein biomarker discovery and quantification. Am Assoc Cancer Res 2010; Prev; 19(4); 953–9.
• 30. Aninagyei, E., Abraham, J., Atiiga, P. et al. Evaluating the potential of using urine and saliva specimens for malaria diagnosis in suspected patients in Ghana. Malar J 2020; 19:349. https://doi.org/10.1186/s12936-020-03427-x