ORIGINAL RESEARCH article
Front. Parasitol.
Sec. Parasite Diagnostics
Volume 4 - 2025 | doi: 10.3389/fpara.2025.1598280
RDT performance through high-throughput bead-based antigen detection during malaria school survey in Senegal
Provisionally accepted
Mamadou Alpha Diallo1*
Ibrahima M Ndiaye1Djiby Sow1Mame Cheikh Seck1Khadim Diongue1Mariama Touré1
Katherine Battle2Bassirou Ngom1Mouhamad Sy1Amy Gaye1Yaye Dié Ndiaye1
Mamane Garba1Aida Sadikh Badiane1Aita Sene1Medoune Ndiop3Jules F Gomis1Sarah K Volkman4Doudou Sene3Bronwyn Macinnis5Ibrahima Diallo3Mouhamadou Ndiaye1Dyann F Wirth4Daouda Ndiaye4- 1CIGASS, Cheikh Anta Diop University, Dakar, Senegal
- 2Institute for Disease Modeling (IDM), Bellevue, Washington, United States
- 3Programme National de Lutte contre le Paludisme, Dakar, Senegal
- 4School of Public Health, Harvard University, Boston, Massachusetts, United States
- 5Broad Institute, Cambridge, MA, United States
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Background: Rapid Diagnostic Tests (RDTs) remain the frontline tool for malaria diagnosis, but their performance in detecting low-density infections is variable and poorly characterized at the population level.Objective: This study aimed to evaluate the diagnostic performance of HRP2-based RDTs by integrating high-throughput bead-based HRP2 quantification into school-based malaria surveys. Methods: A cross-sectional study was conducted in three Senegalese districts (Diourbel, Tambacounda, and Kédougou), enrolling 3,748 school-aged children. All participants were tested using RDTs, and dried blood spots were analyzed with a multiplex bead-based HRP2 assay. A Gaussian mixture model was used to classify HRP2 positivity, and logistic regression assessed the relationship between HRP2 concentration and RDT outcome.The overall RDT positivity rate was 7.2%, with marked heterogeneity across districts (Diourbel: 3.0%, Kédougou: 15.9%, Tambacounda: 7.6%). HRP2 concentration was the strongest predictor of RDT positivity (aOR: 14.55 per log₁₀ increase, 95% CI: 11.14-19.00). RDT limits of detection (LOD₉₅) varied significantly: 3.9 ng/mL in Tambacounda, 121.2 ng/mL in Kédougou, and 204.3 ng/mL in Diourbel.RDTs remain a useful surveillance tool, particularly in moderate-to hightransmission settings. However, reduced sensitivity at lower antigen concentrations in hypoendemic areas highlights the value of complementary high-sensitivity assays for eliminationfocused strategies. Future research should explore the application of these integrated diagnostic approaches in non-SMC regions and investigate additional antigen markers
Keywords: Malaria surveillance, rapid diagnostic tests (RDTs), high-throughput beadbased antigen detection, School-based surveys, Senegal
Received: 22 Mar 2025; Accepted: 08 May 2025.
Copyright: © 2025 Diallo, Ndiaye, Sow, Seck, Diongue, Touré, Battle, Ngom, Sy, Gaye, Dié Ndiaye, Garba, Sadikh Badiane, Sene, Ndiop, Gomis, Volkman, Sene, Macinnis, Diallo, Ndiaye, Wirth and Ndiaye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mamadou Alpha Diallo, CIGASS, Cheikh Anta Diop University, Dakar, Senegal
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