@article{fdi:010073697,
  title = {{O}perational performance of a {P}lasmodium falciparum ultrasensitive rapid diagnostic test for detection of asymptomatic infections in {E}astern {M}yanmar},
  author = {{L}andier, {J}ordi and {H}aohankhunnatham, {W}. and {D}as, {S}. and {K}onghahong, {K}. and {C}hristensen, {P}. and {R}aksuansak, {J}. and {P}hattharakokoedbun, {P}. and {K}ajeechiwa, {L}. and {T}hwin, {M}. {M}. and {J}ang, {I}. {K}. and {I}mwong, {M}. and {W}iladphaingern, {J}. and {L}win, {K}. {M}. and {L}ing, {C}. and {P}roux, {S}. and {D}omingo, {G}. {J}. and {D}elmas, {G}. and {N}osten, {F}. {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n the {G}reater {M}ekong {S}ubregion in {S}outheast {A}sia, malaria elimination strategies need to target all {P}lasmodium falciparum parasites, including those carried asymptomatically. {M}ore than 70% of asymptomatic carriers are not detected by current rapid diagnostic tests ({RDT}s) or microscopy. {A}n {HRP}2-based ultrasensitive {RDT} (u{RDT}) developed to improve the detection of low-density infections was evaluated during prevalence surveys within a malaria elimination program in a low-transmission area of eastern {M}yanmar. {S}urveys were conducted to identify high-prevalence villages. {T}wo-milliliter venous blood samples were collected from asymptomatic adult volunteers and transported to the laboratory. {P}lasmodium parasites were detected by {RDT}, u{RDT}, microscopy, ultrasensitive q{PCR} (u{PCR}), and multiplex enzyme-linked immunosorbent assay ({ELISA}). {T}he sensitivity, specificity, and predictive positive and negative values of {RDT} and u{RDT} were calculated compared to u{PCR} and {ELISA}. {P}arasite and antigen concentrations detected by each test were defined using u{PCR} and {ELISA}, respectively. {A} total of 1,509 samples, including 208 {P}. falciparum-positive samples were analyzed with all tests. {T}he sensitivity of the u{RDT} was twofold higher than that of {RDT}, 51.4% versus 25.2%, with minor specificity loss, 99.5% versus 99.9%, against the combined reference (u{PCR} plus {ELISA}). {T}he geometric mean parasitemia detected by u{RDT} in {P}. falciparum monospecific infections was 3,019 parasites per ml (95% confidence interval [95% {CI}], 1,790 to 5,094; n = 79) compared to 11,352 parasites per ml (95% {CI}, 5,643 to 22,837; n = 38) by {RDT}. {T}he sensitivities of u{RDT} and {RDT} dropped to 34.6% and 15.1%, respectively, for the matched tests performed in the field. {T}he u{RDT} performed consistently better than {RDT} and microscopy at low parasitemias. {I}t shows promising characteristics for the identification of high-prevalence communities and warrants further evaluation in mass screening and treatment interventions.},
  keywords = {{P}lasmodium falciparum ; asymptomatic infection ; low density parasitemia ; low transmission setting ; malaria ; rapid tests ; ultrasensitive {RDT} ; {MYANMAR}},
  booktitle = {},
  journal = {{J}ournal of {C}linical {M}icrobiology},
  volume = {56},
  numero = {8},
  pages = {e00565--18 [16 p.]},
  ISSN = {0095-1137},
  year = {2018},
  DOI = {10.1128/jcm.00565-18},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073697},
}