Evaluation of a dipstick test for the rapid diagnosis of imported malaria among patients presenting within the network TropNetEurop

Lack of experience on the part of involved laboratory personnel frequently complicates swift diagnosis of imported falciparum malaria in non-endemic a reas. Diagnostic tools based on the dipstick principle for the detection of plasmodial histidine-rich protein 2 have been marketed for several years a nd have been extensively evaluated. Recently, a test kit capable of detecti ng antigen of Plasmodium falciparum and P. vivax has been introduced. In or der to evaluate this newly available tool, specimens from 664 patients were screened during the course of a prospective multicentre study within the E uropean Network on Imported Infectious Disease Surveillance (TropNetEurop). Among the screened specimens, samples from 82 patients (12.3%) were positi ve for falciparum malaria using expert microscopy. A further 17 samples wer e positive for vivax malaria. The evaluated test kit performed with a sensi tivity of 87.8% and a specificity of 99% for detection of falciparum malari a. Respective values for vivax malaria were 76.5% and 100%. Dipstick tests have the potential of improving the speed and accuracy of the diagnosis of falciparum malaria, especially if non-specialized laboratories are involved . However, decreased values of sensitivity and specificity, in comparison w ith expert microscopy, still impose a clear limit on the usefulness of the currently available kits.