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Post-treatment duration of positivity for standard and ultra-sensitive Plasmodium falciparum antigen-based rapid diagnostic tests, a cohort study from a low-endemic setting in NamibiaResearch in context

Authors :
Henry Ntuku
Brooke Whittemore
Lucille Dausab
Ihn Kyung Jang
Allison Golden
William Sheahan
Xue Wu
Hannah Slater
Gonzalo J. Domingo
Smita Das
Elias Duarte
Lydia Eloff
Teun Bousema
Kjerstin Lanke
Cara Smith Gueye
Lisa M. Prach
Jaishree Raman
Petrina Uusiku
Stark Katokele
Roly Gosling
Bryan Greenhouse
Davis Mumbengegwi
Michelle S. Hsiang
Source :
EBioMedicine, Vol 111, Iss , Pp 105489- (2025)
Publication Year :
2025
Publisher :
Elsevier, 2025.

Abstract

Summary: Background: The standard malaria rapid diagnostic test (RDT) and newer ultra-sensitive RDT (uRDT) target Plasmodium falciparum histidine rich protein-2 (HRP2), which persists post-treatment. The duration of test positivity has not previously been studied in a low transmission setting. Methods: We conducted a longitudinal cohort study in a low transmission setting in Namibia. RDT-positive individuals identified through passive and active case detection were treated and followed weekly for testing by RDT and uRDT, HRP2 quantification, quantitative PCR (qPCR) of parasitemia, and quantitative reverse transcriptase PCR (RT-PCR) of gametocytemia, until RDT and uRDT were negative for two consecutive weeks. Determinants of persistent positivity were identified using Cox proportional hazards models. Findings: Among 137 participants with complete follow-up and no evidence of resurgence during follow-up, median duration of positivity was 42 days (range: 3−98 range) for RDT, compared to 67 days (range 12–105) for uRDT. In a sub-analysis of those with laboratory data before treatment (n = 60), drug resistance did not explain persistent positivity. Younger age (

Details

Language :
English
ISSN :
23523964
Volume :
111
Issue :
105489-
Database :
Directory of Open Access Journals
Journal :
EBioMedicine
Publication Type :
Academic Journal
Accession number :
edsdoj.4ad7836bf6c14668b3f5a84130ee3001
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ebiom.2024.105489