Detection of malarial parasite in urine of malaria patients: a future diagnostic approach

Vyankatesh T. Anchinmane, Rakesh T. Shedge


Background: Current definitive screening for active malaria infection necessitates drawing blood. The non-invasive, cost-effective malaria tests that minimize the need for blood collection are the need of time. QDx Malaria PAN/Pf rapid malaria card test (QDx rapid malaria test) is an immunochromatographic test that detects the presence of malarial antigens (pLDH and HRP-2) in the blood sample for the diagnosis of malaria. These malarial antigens are also released in the urine. The study was conducted to determine the sensitivity, specificity and accuracy of the QDx Rapid Malaria test for diagnosis of malaria in blood and urine.

Methods: Blood and urine specimens were obtained from 75 malaria blood smear positive cases (test samples) and 25 malarial negative cases (controls). Then urine and blood specimen of each case were evaluated for QDx rapid malaria test. Using microscopy as gold standard, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the QDx rapid malaria test for urine and blood were calculated.

Results: The accuracy of QDx rapid malaria test for malarial parasite detection was 97% for blood and 38 % for urine.

Conclusions: Rapid malaria test processed with urine may be a useful non-invasive and cost-effective malaria diagnostic technique in future.



Rapid malaria test, Malarial antigens, Urine

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Mharakurwa S, Simoloka C, Thuma PE, Shiff CJ, Sullivan DJ. PCR detection of plasmodium falciparum in human urine and saliva samples. Malaria J. 2006;5:103.

Kakkilaya BS. Rapid diagnosis of malaria. Lab Med. 2003;8(34):602-8.

Gillet P, Mori M, Esbroeck MV, Van den Ende J, Jacobs J. Assessment of the prozone effect in malaria rapid diagnostic tests. Malaria J. 2009;8:271.

Genton B, Paget S, Beck HP, Gibson N, Alpers MP, Hi. Diagnosis of plasmodium falciparum infection using ParaSight(R)-F test in blood and urine of Papua New Guinean children. J Southeast Asian J Trop Med Public Health.1998;29(1):35-40.

Wilson NO, Adjei AA, Anderson W, Baidoo S, Stiles JK. Detection of plasmodium falciparum histidine-rich protein II in saliva of malaria patients. Am J Trop Med Hyg. 2008;78(5):733-5.

Rodriguez-Del Valle M, Quakyi IA, Amuesi J, Quaye JT, Nkrumah FK, Taylor DW. Detection of antigens and antibodies in the urine of humans with plasmodium falciparum malaria. J Clin Microbiol. 1991;29(6):1236-42.

Zerpa N, Pabón R, Wide A, Gavidia M, Medina M, Caceres JL, et al. Evaluation of the OptiMAL® test for diagnosis of malaria in Venezuela. Invest Clin. 2008;49(1):93-101.

Katzin AM, Kimura ES, Alexandre C, Ramos AM. Detection of antigens in urine of patients with acute falciparum and vivax malaria Infections. Am J Trop Med Hyg. 1991;45(4):453-62.

Coleman RE, Maneechai N, Ponlawat A, Kumpitak C, Rachapaew N, Miller RS, et al. Failure of the OptiMAL rapid malaria test as a tool for the detection of asymptomatic malaria in an area of Thailand endemic for plasmodium falciparum and p. vivax. American J Trop Med Hygiene. 2002;67(6):563-5.