Short report: Field evaluation of posttreatment sensitivity for monitoring parasite clearance of Plasmodium falciparum malaria by use of the Determine™ Malaria pf test in central India

Abstract

The posttreatment performance of the Plasmodium falciparum histidine-rich protein rapid diagnostic test Determine™ Malaria pf (Abbott Laboratories, Tokyo, Japan) was assessed in 70 patients in central India with uncomplicated falciparum malaria who were treated with chloroquine, sulfadoxine-pyrimethamine, and arteether. Data were compared with those of microscopy. Results revealed that the sensitivity for predicting recrudescence by means of the Determine™ test after treatment with chloroquine on Day 14 was 75%, with 50% specificity. However, antigenemia was detected in 16% of patients as late as Day 21 in sulfadoxine-pyrimethamine-treated subjects with a drug-sensitive response. Clearance of parasitemia in thick blood smear and clearance of antigenemia appeared to parallel each other only in arteether-treated subjects. The observed diagnostic trends therefore mean that the potential of the Determine™ test to detect recrudescent infection is limited.