Systematic Analysis of Plasmodium Falciparum Histidine Rich Protein-2 (Pf HRP-2) Based Rapid Diagnostic Test for Malaria

Abstract

The Philippines is known to have malaria as an endemic infection primarily affecting people in areas like Palawan and Mindoro. With the lack of equipment such as microscopes for accurate diagnosis, rapid diagnostic tests (RDTs) have been widely used for the initial diagnosis of infected people in remote areas. However, only limited studies are published locally that compile and summarize related studies about Plasmodium falciparum Histidine Rich Protein-2 (PfHRP-2) based RDTs. Through a systematic review of relevant literature, two PfHRP-2-based RDTs were compared in terms of their sensitivity and specificity with reference to microscopy as the gold standard method. The journals and articles were systematically searched, screened through various stages for relevance, and assessed for quality. Following that, statistical data were extracted, gathered, and analyzed. The meta-analysis showed that Paracheck-pf ® performed better than Parahit-f ® in terms of its pooled sensitivity (91.8% and 59.9%, respectively) and specificity (85.0% and 98.1%, respectively). Consequently, Paracheck-pf ® demonstrated greater accuracy than Parahit-f ® based on the pooled DOR (91.184 and 42.013, respectively) and AUC (0.956 and 0.843, respectively). These RDTs were greatly influenced by factors such as parasitemia levels, kit quality, storage requirements and temperature, performance of consumers, etc. With this, the use of RDTs may be utilized, as an initial diagnosis for the disease, as there is still a need to use the gold standard microscopy to confirm the diagnosis.