Reply to Rossi et al

To the Editor—We thank Rossi and colleagues for sharing their findings from Cambodia [1], which complement our recent article reporting limitations of rapid diagnostic testing in patients with suspected malaria from Swaziland, a low-endemic country in southern Africa aiming to eliminate malaria [2]. Using polymerase chain reaction (PCR) as gold standard, they performed a diagnostic accuracy evaluation of rapid diagnostic testing (RDT) to diagnose Plasmodium falciparum in subjects with suspected malaria. Sensitivity was low at 72% (compared to 52% in our study). Low-density infection, defined as <100 parasites/μL, explained 75% of false-negative results (compared to 76% in our study). With the large sample size of 4382 patients, sampling of all RDT negatives (vs selective sampling employed in our study), and use of quantitative PCR, the study is a useful addition to the few published studies on performance of RDT to assess symptomatic malaria in low-transmission settings [1, 3, 4].

http://ift.tt/2zSqMk7