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Persistencia de antígenos de pruebas diagnósticas rápidas en mujeres embarazadas en Nanoro, Burkina Faso, e implicaciones para el diagnóstico de la malaria durante el embarazo.
Author(s) -
Kattenberg Johanna H.,
Tahita Christian M.,
Versteeg Inge A. J.,
Tinto Halidou,
TraoréCoulibaly Maminata,
Schallig Henk D. F. H.,
Mens Petra F.
Publication year - 2012
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2012.02975.x
Subject(s) - malaria , medicine , dihydrofolate reductase , pregnancy , antigen , rapid diagnostic test , plasmodium falciparum , obstetrics , immunology , persistence (discontinuity) , gastroenterology , gynecology , biology , methotrexate , geotechnical engineering , engineering , genetics
Objectives To evaluate persistence of several Plasmodium antigens in pregnant women after treatment and compare diagnostics during treatment follow‐up. Methods Thirty‐two pregnant women ( N = 32) with confirmed malaria infection by a histidine‐rich protein 2 (HRP2)‐based rapid diagnostic test (RDT) and microscopy were followed for 28 days after artemisinin‐based combination therapy (ACT). A Plasmodium lactate dehydrogenase (pLDH)‐based RDT and two ELISAs based on the detection of dihydrofolate reductase–thymidylate synthase (DHFR‐TS) and haeme detoxification protein (HDP) were compared with each other and to RT‐PCR at each visit. Results The mean visit number (95% confidence interval) on which the HRP2‐based RDT was still positive after treatment was 3.4 (2.7–4.1) visits with some patients still positive at day 28. This is significantly later than the pLDH‐based RDT [0.84 (0.55–1.1)], microscopy (median 1, range 1–3), DHFR‐TS‐ELISA [1.7 (1.1–2.3)] and RT‐PCR (median 2, range 1–5) ( P < 0.05), but not significantly later than HDP‐ELISA [2.1 (1.6–2.7)]. Lower gravidity and higher parasite density at day 0 resulted in significantly longer positive results with most tests ( P < 0.05). Conclusions HRP2 can persist up to 28 days after ACT treatment; therefore, this test is not suitable for treatment follow‐up in pregnant women and can generate problems when using this test during intermittent preventive treatment (IPTp). DHFR‐TS is less persistent than HRP2, making it a potentially interesting target for diagnosis.