Correspondence

Correction

Performance of Two Rapid Tests for Plasmodium falciparum Malaria in Patients with Rheumatoid Factors

N Engl J Med 1998; 338:1075-1076April 9, 1998

Article

To the Editor:

Light-microscopical examination of blood smears is the cornerstone of the diagnosis of malaria. Recently, two rapid immunodiagnostic tests, the ParaSight F test (Becton Dickinson, Cockeysville, Md.)1 and the ICT Malaria Pf test (ICT Diagnostics, Balgowlah, Australia) ,2 were developed for the diagnosis of Plasmodium falciparum infection. Both are immunochromatographic tests based on the detection of circulating P. falciparum histidine-rich protein-2 antigen in whole blood.3 Recently, Laferl [not Laferi, as published] et al., in a letter to the editor,4 and Bartoloni et al.5 reported false positive results of ParaSight F tests in 67 percent and 68 percent of patients with rheumatoid factors, respectively. Since the production of rheumatoid factors occurs commonly in patients with a variety of infectious and noninfectious diseases, as well as in 5 percent of the healthy people, caution was urged in the use of the ParaSight F test.

With the aim of determining whether the ICT Malaria Pf test presents the same limitation as the ParaSight F test, we performed both tests on whole-blood samples obtained from 23 patients with rheumatoid factors and thick blood films that were negative for malaria. The ParaSight F test was positive in 19 patients (83 percent), whereas the ICT Malaria Pf test had no false positive results. The different performance of the two rapid tests, both based on the capture of histidine-rich protein-2 antigen, is probably due to the fact that the antibody used in the ICT Malaria Pf test is different from that used in the ParaSight F test.

Alessandro Bartoloni, M.D.
Università di Firenze, 50121 Florence, Italy

Guido Sabatinelli, M.D.
Istituto Superiore di Sanità, 00161 Rome, Italy

Maurizio Benucci, M.D.
Azienda Sanitaria Firenze, 50122 Florence, Italy

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   Raffaella Bianucci, Grazia Mattutino, Rudy Lallo, Philippe Charlier, Hélène Jouin-Spriet, Alberto Peluso, Thomas Higham, Carlo Torre, Emma Rabino Massa. (2008) Immunological evidence of Plasmodium falciparum infection in an Egyptian child mummy from the Early Dynastic Period. Journal of Archaeological Science 35:7, 1880-1885
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   Bevinje Srinivas Kakkilaya. (2003) Rapid Diagnosis of Malaria. Laboratory Medicine 34:8, 602-608
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4. 4

   T. Hanscheid. (1999) Diagnosis of malaria: a review of alternatives to conventional microscopy. Clinical and Laboratory Haematology 21:4, 235-245
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   Matthias Trachsler, Patricia Schlagenhauf, Robert Steffen. (1999) Feasibility of a rapid dipstick antigen-capture assay for self-testing of travellers' malaria. Tropical Medicine & International Health 4:6, 442-447
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   MP Grobusch, U Alpermann, S Schwenke, T Jelinek, DC Warhurst. (1999) False-positive rapid tests for malaria in patients with rheumatoid factor. The Lancet 353:9149, 297
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