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8/8/2019 Rapid test for malaria
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INTRODUCTION
MALARIA INFECTION
life-threatening disease caused by parasites ofthespeciesPlasmodium
infectious
preventableand curable prevention: prophylactic antibiotic, doxycycline
treatment:combination of drugs knownasartemisinin-based
combinationtherapies (ACTs)
MOT:Bite ofinfected vectormosquito, female Anophelesminimus flavirotris
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SpeciesofPlasmodiumparasites: Can infect humans:
P. falciparum P.vivax
P.ovale P.malariae
INTRODUCTION
P. falciparum isthemost deadly.
P. falciparum and P. vivax arethemost prevalent.
Female Anophelesminimus flavirostris
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INTRODUCTION
Symptoms:first commonsymptoms whichusually appear10 to15 daysaftera personisinfected.
fever headache
chills vomiting
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INTRODUCTION
Ofutmostimportanceforbetterpatientmanagementand speedy recovery are:
Early detection
- Cerebralmalarialand drugresistanceassociated withfalciparum
malaria- Morbidity
Early differentiation
- course oftreatmentis dependent onthespecies
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DIAGNOSTIC TESTS
Blood Smear Gold standard
Rapid TestforMalaria Pan + Pv + Pf
FirstSign ParaView-3
Isarapid self-performing,qualitative, two sitesandwichimmunoassayutilizingwhole blood
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DIAGNOSTIC TESTS
Rapid Test for Malaria Pan + Pv + PfFirstSign ParaView-3
PARASITE DETECTION OF
P. falciparum P. falciparum specific histidine richprotein-2 (Pf. HRP-2)
P. vivax P. vivax specific parasitelactate dehydrogenase (pLDH)
P. ovale and P. malaria Panmalariaspecific parasite
lactate dehydrogenase(pLDH)
Detectionsystemis based on:
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isa watersoluble protein expressed onthered cellmembranesurface produced by theasexualstagesand gametocytes ofP.
falciparum
shownto remaininthe blood foratleast28 daysaftertheinitiation ofantimalarial therapy
solubleglycolytic enzyme produced by theasexualand sexualstages ofthelive
parasites itis presentinand released fromthe parasiteinfected
erythrocytes. Ithas beenfound inall 4 humanmalariaspecies, and differentisomers of pLDH foreach ofthe 4speciesexist
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PRINCIPLE
Immunochromatographic assay
-colloidalgold conjugate ofanti-HRP-2antibody,antiP. Vivax specific pLDH antibody and anti PanspecificpLDH antibody complexes HRP-2/corresponding pLDH
inthelysed sample.
-unreacted conjugatesalong withtherabbitantiseracolloidalgold conjugateand unbound complex(ifany),movesfurtheronthemebrane and are
subsequently immobilized by anti-rabbitantibodiescoated onthemembraneatthemembraneatthecontrolregion
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PRINCIPLE
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ANTIBODY AND ANTIGEN
ANTIBODY ANTIGEN
Monoclonalanti Pf.- HRP2antibody
monoclonalantiP.vivaxspecific pLDH antibody
monoclonalanti panspecific pLDH antibody
anti-rabbitantibody(control)
Pf. HRP2
P.vivax
Pan
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REAGENTS AND
MATERIALS USED1. TEST DEVICE:
Containsmembrane assembly
pre-dispensed with:
monoclonalanti- Pf. HRP2antibody-colloidalgold conjugate
monoclonalanti P.vivax specific pLDHantibody-colloidalgold conjugate
monoclonalanti panspecific pLDHantibody-colloidalgold conjugate
Rabbitglobulin colloidalgold conjugate
2. DESSICANT POUCH3. 5l SAMPLE LOOP
4. CLEARING BUFFER IN A DROPPER BOTTLE
5. PACKAGE INSERT
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DESCRIPTIONS OF THE TEST
Canspecifically detectand differentiate Pf & Pv-which constituteabout 90% ofthetotalmalaria occurrence
globally.
Good clinicalsensitivity and specificity >98% forP.falciparum malariae-dueto HRP-2 based detection.
Ableto monitorsuccess ofanti-malarialtherapy-through Pan band.
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LIMITATIONS OF THE TEST
Cannotspecifically detectand differentiateP.malariae andP.ovale.
HRP-2 isnotsecreted ingametogony stage. Hence,in carriers, the HRP-2may beabsent.
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PROCEDURES
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INTERPRETATION OF RESULTS
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INTERPRETATION OF RESULTS
Negative (-)A negativeresultindicatestheabsence ofany malarialparasiteinthesample
Positive (+):
A positiveresult onthe Pfregionindicatesthe presence ofP. falciparum infection
A positiveresult onthe Pvregionindicatesthe presence ofP.vivax infection
A positiveresult onthe Panregion butanegativeresult oneitherPfand Pvregionsindicatetheinfection of othermalarial parasitespecies ( P.malariae and P.ovale).
A positiveresult onalltheregionsindicateamixed malarial
parasiteinfection
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MANNER OF REPORTING
Negative (-)Only one pink/pink-purple band appearsatthe controlregionC
Positive (+):
1. P. falciparum malariaInadditionto the control band, a pink/purple band appearsat
the Pfand Panregionsrespectively
2. P. vivax malariaInadditionto the control band, a pink/purple band appearsat
Pvand Panregionsrespectively
3. OtherspeciesInadditionto the control band, one pink/purple band appears
only atthe Panregion
4. Mixed infectionInadditionto the control band, a pink/purple band appearsat
Pf, Pvand Panregions