Can malaria rapid diagnostic tests be used to detect simian malaria?

IF 2.5 3区医学 Q2 PARASITOLOGY

Acta tropica Pub Date : 2025-09-04 DOI:10.1016/j.actatropica.2025.107819

Wanassanan Madmanee , Nicholas P.J. Day , Nicholas J. White , Arjen M. Dondorp , Suchinda Malaivijitnond , Mallika Imwong

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Abstract

Background

The increasing recognition of zoonotic malaria, particularly from Plasmodium species infecting non-human primates (NHP), poses significant diagnostic challenges. Performance of human malaria Rapid Diagnostic Tests (RDTs) has not been evaluated in simian malaria.

Methods

A total of 131 blood samples from NHP hosts with confirmed malaria were analyzed using 14 different commercially available RDTs, detecting the antigens P. falciparum HRP2 (PfHRP2) and either Plasmodium Lactate-dehydrogenase (pLDH) or aldolase. Thirty samples from macaque monkeys without malaria served as controls. Subgroup analysis assessed RDT sensitivity in samples with parasite densities above the conventional cut-off of >200 parasites/μL. Quantitative PCR (qPCR) was used as reference standard.

Results

Observed Plasmodium species and geometric mean parasite genome equivalents in the blood samples from monkeys with malaria were P. cynomolgi (73.2 parasites/μL), P. inui (272.8 parasites/μL), and P. coatneyi (158.4 parasites/μL. Overall RDT sensitivity ranged from 34.2 to 94.3 % across RDT brands and was higher in samples with parasite densities exceeding 200 parasites/μL, reaching >90 % sensitivity for the detection of for P. cynomolgi, P. inui, or P. coatneyi in the best-performing RDT. False positive test results were not observed in the control samples from monkeys without malaria, but in those with malaria, a PfHRP2 positive test result was observed in 1 % to 17 % of the RDTs. Overall, the performance of pLDH-based tests was similar to aldolase-based tests. Observed test sensitivity was highest for the detection of P. inui infections.

Conclusions

The performance of RDTs in detecting simian malaria varies according to RDT brand, infecting Plasmodium species, and parasite density. Most RDT brands show good performance to detect simian Plasmodium species when parasite density exceeds 200 parasites/µL.

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疟疾快速诊断测试能否用于检测类人猿疟疾？

背景：对人畜共患疟疾的认识日益增加，特别是来自感染非人类灵长类动物（NHP）的疟原虫的认识，给诊断带来了重大挑战。人类疟疾快速诊断试验（RDTs）在类人猿疟疾中的表现尚未得到评估。方法：采用14种不同的市购RDTs检测恶性疟原虫HRP2 （PfHRP2）抗原和乳酸脱氢酶（pLDH）或醛缩酶（aldolase）抗原，对131份确诊的NHP疟疾宿主血样进行分析。30个没有疟疾的猕猴样本作为对照。亚群分析评估了在寄生虫密度高于常规临界值（约200只/μL）的样品中RDT的敏感性。以定量PCR （qPCR）作为对照标准。结果：在疟疾猴血样中观察到的疟原虫种类和几何平均疟原虫基因组当量分别为：食蟹假单胞疟原虫（73.2个/μL）、犬假单胞疟原虫（272.8个/μL）和长毛假单胞疟原虫（158.4个/μL）。不同RDT品牌的RDT总灵敏度在34.2 ~ 94.3%之间，在寄生虫密度超过200只/μL的样品中灵敏度更高，其中对P. cynomolgi、P. inui和P. coatneyi的检测灵敏度达到了bb0.90%。在没有疟疾的猴子的对照样本中未观察到假阳性检测结果，但在患有疟疾的猴子中，在1%至17%的rdt中观察到PfHRP2阳性检测结果。总体而言，基于pldh的测试的性能与基于醛缩酶的测试相似。观察到的试验灵敏度最高的是检出猪链球菌感染。结论：RDT检测类人猿疟疾的效果因RDT品牌、感染疟原虫种类和寄生虫密度的不同而不同。当寄生虫密度超过200只/µL时，大多数RDT品牌对猿类疟原虫的检测效果较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta tropica 医学-寄生虫学

CiteScore

5.40

自引率

11.10%

发文量

383

审稿时长

37 days

期刊介绍： Acta Tropica, is an international journal on infectious diseases that covers public health sciences and biomedical research with particular emphasis on topics relevant to human and animal health in the tropics and the subtropics.