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RDT performance through high-throughput bead-based antigen detection during malaria school survey in Senegal

Article scientifique 2025 Anglais

Résumé

Background Rapid Diagnostic Tests (RDTs) remain the frontline tool for malaria diagnosis, but their performance in detecting low-density infections is variable and poorly characterized at the population level. Objective This study aimed to evaluate the diagnostic performance of HRP2-based RDTs by integrating high-throughput bead-based HRP2 quantification into school-based malaria surveys. Methods A cross-sectional study was conducted in three Senegalese districts (Diourbel, Tambacounda, and Kédougou), enrolling 3,748 school-aged children. All participants were tested using RDTs, and dried blood spots were analyzed with a multiplex bead-based HRP2 assay. A Gaussian mixture model was used to classify HRP2 positivity, and logistic regression assessed the relationship between HRP2 concentration and RDT outcome. Results The overall RDT positivity rate was 7.2%, with marked heterogeneity across districts (Diourbel: 3.0%, Kédougou: 15.9%, Tambacounda: 7.6%). HRP2 concentration was the strongest predictor of RDT positivity (aOR: 14.55 per log 10 increase, 95% CI: 11.14–19.00). RDT limits of detection (LOD 95 ) varied significantly: 3.9 ng/mL in Tambacounda, 121.2 ng/mL in Kédougou, and 204.3 ng/mL in Diourbel. Conclusion RDTs remain a useful surveillance tool, particularly in moderate- to high-transmission settings. However, reduced sensitivity at lower antigen concentrations in hypo-endemic areas highlights the value of complementary high-sensitivity assays for elimination-focused strategies. Future research should explore the application of these integrated diagnostic approaches in regions without seasonal malaria chemoprophylaxis intervention.

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Diallo, M., Ndiaye, I., Sow, D., Seck, M., Diongue, K., Touré, M., Battle, K., Ngom, B., Sy, M., Gaye, A., Ndiaye, Y., Garba, M., Badiane, A., Sène, A., Ndiop, M., Gomis, J., Volkman, S., Sène, D., MacInnis, B., Diallo, I., Ndiaye, M., Wirth, D., Ndiaye, D. (2025). RDT performance through high-throughput bead-based antigen detection during malaria school survey in Senegal. https://doi.org/10.3389/fpara.2025.1598280

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Auteur(s)

Mamadou Alpha Diallo Ibrahima Ndiaye Djiby Sow Mame Cheikh Seck Khadim Diongue Mariama Touré Katherine E. Battle Bassirou Ngom Mouhamad Sy Amy Gaye Yaye Dié Ndiaye Mamane Nassirou Garba Aïda Sadikh Badiane Aita Sène Médoune Ndiop Jules F. Gomis Sarah K. Volkman Doudou Sène Bronwyn MacInnis Ibrahima Diallo Mouhamadou Ndiaye Dyann F. Wirth Daouda Ndiaye

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