@article{fdi:010078122,
  title = {{P}revalence and clinical impact of malaria infections detected with a highly sensitive {HRP}2 rapid diagnostic test in {B}eninese pregnant women [+ correction 2020, vol. 19, no 1, art. 328]},
  author = {{B}riand, {V}al{\'e}rie and {C}ottrell, {G}illes and {N}dam, {N}. {T}. and {M}artianez-{V}endrell, {X}. and {V}ianou, {B}. and {M}ama, {A}. and {K}ouwaye, {B}. and {H}ouze, {S}. and {B}ailly, {J}. and {G}baguidi, {E}. and {S}ossou, {D}. and {M}assougbodji, {A}. and {A}ccrombessi, {M}. and {M}ayor, {A}. and {D}ing, {X}. {C}. and {F}ievet, {N}adine},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {W}hile sub-microscopic malarial infections are frequent and potentially deleterious during pregnancy, routine molecular detection is still not feasible. {T}his study aimed to assess the performance of a {H}istidine {R}ich {P}rotein 2 ({HRP}2)-based ultrasensitive rapid diagnostic test (u{RDT}, {A}lere {M}alaria {A}g {P}f) for the detection of infections of low parasite density in pregnant women. {M}ethods {T}his was a retrospective study based on samples collected in {B}enin from 2014 to 2017. {A} total of 942 whole blood samples collected in 327 women in the 1st and 3rd trimesters and at delivery were tested by u{RDT}, conventional {RDT} (c{RDT}, {SD} {BIOLINE} {M}alaria {A}g {P}f), microscopy, quantitative polymerase chain-reaction (q{PCR}) and {L}uminex-based suspension array technology targeting {P}. falciparum {HRP}2. {T}he performance of each {RDT} was evaluated using q{PCR} as reference standard. {T}he association between infections detected by u{RDT}, but not by c{RDT}, with poor maternal and birth outcomes was assessed using multivariate regression models. {R}esults {T}he overall positivity rate detected by c{RDT}, u{RDT}, and q{PCR} was 11.6% (109/942), 16.2% (153/942) and 18.3% (172/942), respectively. {O}ut of 172 q{PCR}-positive samples, 68 were u{RDT}-negative. u{RDT} had a significantly better sensitivity (60.5% [52.7-67.8]) than c{RDT} (44.2% [36.6-51.9]) and a marginally decreased specificity (93.6% [91.7-95.3] versus 95.7% [94.0-97.0]). {T}he gain in sensitivity was particularly high (33%) and statistically significant in the 1st trimester. {O}nly 28 (41%) out of the 68 samples which were q{PCR}-positive, but u{RDT}-negative had detectable but very low levels of {HRP}2 (191 ng/m{L}). {I}nfections that were detected by u{RDT} but not by c{RDT} were associated with a 3.4-times (95%{CI} 1.29-9.19) increased risk of anaemia during pregnancy. {C}onclusions {T}his study demonstrates the higher performance of u{RDT}, as compared to c{RDT}s, to detect low parasite density {P}. falciparum infections during pregnancy, particularly in the 1st trimester. u{RDT} allowed the detection of infections associated with maternal anaemia.},
  keywords = {{M}alaria ; {P}regnancy ; {A}frica ; {D}iagnostic tests ; {HRP}-2 antigen ; {BENIN}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {19},
  numero = {1},
  pages = {188 [12  + correction vol. 19, no 1, art. 328]},
  year = {2020},
  DOI = {10.1186/s12936-020-03261-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078122},
}