High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda
BackgroundMalaria remains a significant health burden, particularly in Uganda, which has one of the highest incidence rates globally. Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis due to their ease of use and affordability in resource-limited settings. However, false-positive R...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Malaria |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmala.2025.1545825/full |
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| author | Susanne E. Mortazavi Susanne E. Mortazavi Allan Lugaajju Anna-Clara Ivarsson Sara Karlsson Söbirk Sara Karlsson Söbirk Hans Norrgren Hans Norrgren Kristina E. M. Persson Kristina E. M. Persson |
| author_facet | Susanne E. Mortazavi Susanne E. Mortazavi Allan Lugaajju Anna-Clara Ivarsson Sara Karlsson Söbirk Sara Karlsson Söbirk Hans Norrgren Hans Norrgren Kristina E. M. Persson Kristina E. M. Persson |
| author_sort | Susanne E. Mortazavi |
| collection | DOAJ |
| description | BackgroundMalaria remains a significant health burden, particularly in Uganda, which has one of the highest incidence rates globally. Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis due to their ease of use and affordability in resource-limited settings. However, false-positive RDT results may lead to unnecessary antimalarial treatments and missed diagnoses of other febrile conditions. This study aimed to evaluate the diagnostic accuracy of RDT compared to microscopy and loop-mediated isothermal amplification (LAMP) in a malaria-endemic region of Uganda.MethodsA prospective study was conducted with 225 febrile individuals diagnosed with malaria using RightSign Malaria Ag HRPII/Pan Plasmodium Aldolase RDT (Hangzhou Biotest Biotech Co., Ltd., China) at Iganga General Hospital, Uganda. Blood samples were analyzed using microscopy and LAMP. Demographic information, malaria history, and parasitemia levels were also recorded.ResultsAmong the RDT-positive participants, 48% tested negative by microscopy, and 45% of these were also negative by LAMP, indicating that 20% of all RDT-positive individuals were likely false positives. Overall, 66% (149/225) of RDT-positive cases were confirmed as true positives.ConclusionsThis study identified a high rate of false positives with the tested RDT, risking inappropriate treatment and missed diagnoses of other illnesses. It is essential that healthcare facilities use RDTs validated and recommended by the World Health Organization (WHO) to ensure high specificity and accuracy, particularly in resource-limited settings where alternative diagnostic methods may not be available. |
| format | Article |
| id | doaj-art-4eff7e22c6fa4c94ac5be8f47c26b954 |
| institution | Kabale University |
| issn | 2813-7396 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Malaria |
| spelling | doaj-art-4eff7e22c6fa4c94ac5be8f47c26b9542025-01-31T06:39:47ZengFrontiers Media S.A.Frontiers in Malaria2813-73962025-01-01310.3389/fmala.2025.15458251545825High rate of false positive malaria rapid diagnostic tests in a district hospital in UgandaSusanne E. Mortazavi0Susanne E. Mortazavi1Allan Lugaajju2Anna-Clara Ivarsson3Sara Karlsson Söbirk4Sara Karlsson Söbirk5Hans Norrgren6Hans Norrgren7Kristina E. M. Persson8Kristina E. M. Persson9Department of Laboratory Medicine, Lund University, Lund, SwedenDepartment of Infectious Diseases, Skåne University Hospital, Lund, SwedenCollege of Health Sciences, Makerere University, Kampala, UgandaClinical Microbiology, Infection Prevention and Control, Office for Medical Services, Region Skåne, Lund, SwedenClinical Microbiology, Infection Prevention and Control, Office for Medical Services, Region Skåne, Lund, SwedenDivision of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, SwedenDepartment of Infectious Diseases, Skåne University Hospital, Lund, SwedenDivision of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, SwedenDepartment of Laboratory Medicine, Lund University, Lund, SwedenClinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, SwedenBackgroundMalaria remains a significant health burden, particularly in Uganda, which has one of the highest incidence rates globally. Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis due to their ease of use and affordability in resource-limited settings. However, false-positive RDT results may lead to unnecessary antimalarial treatments and missed diagnoses of other febrile conditions. This study aimed to evaluate the diagnostic accuracy of RDT compared to microscopy and loop-mediated isothermal amplification (LAMP) in a malaria-endemic region of Uganda.MethodsA prospective study was conducted with 225 febrile individuals diagnosed with malaria using RightSign Malaria Ag HRPII/Pan Plasmodium Aldolase RDT (Hangzhou Biotest Biotech Co., Ltd., China) at Iganga General Hospital, Uganda. Blood samples were analyzed using microscopy and LAMP. Demographic information, malaria history, and parasitemia levels were also recorded.ResultsAmong the RDT-positive participants, 48% tested negative by microscopy, and 45% of these were also negative by LAMP, indicating that 20% of all RDT-positive individuals were likely false positives. Overall, 66% (149/225) of RDT-positive cases were confirmed as true positives.ConclusionsThis study identified a high rate of false positives with the tested RDT, risking inappropriate treatment and missed diagnoses of other illnesses. It is essential that healthcare facilities use RDTs validated and recommended by the World Health Organization (WHO) to ensure high specificity and accuracy, particularly in resource-limited settings where alternative diagnostic methods may not be available.https://www.frontiersin.org/articles/10.3389/fmala.2025.1545825/fullmalariaPlasmodiumfalse positiverapid diagnostic testmicroscopyLAMP |
| spellingShingle | Susanne E. Mortazavi Susanne E. Mortazavi Allan Lugaajju Anna-Clara Ivarsson Sara Karlsson Söbirk Sara Karlsson Söbirk Hans Norrgren Hans Norrgren Kristina E. M. Persson Kristina E. M. Persson High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda Frontiers in Malaria malaria Plasmodium false positive rapid diagnostic test microscopy LAMP |
| title | High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda |
| title_full | High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda |
| title_fullStr | High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda |
| title_full_unstemmed | High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda |
| title_short | High rate of false positive malaria rapid diagnostic tests in a district hospital in Uganda |
| title_sort | high rate of false positive malaria rapid diagnostic tests in a district hospital in uganda |
| topic | malaria Plasmodium false positive rapid diagnostic test microscopy LAMP |
| url | https://www.frontiersin.org/articles/10.3389/fmala.2025.1545825/full |
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