{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:26:06Z","timestamp":1787009166641,"version":"build-2736575974"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microscopy is the gold standard for malaria diagnosis but is dependent on trained personnel. Rapid diagnostic tests (RDTs) form the mainstay of diagnosis in endemic areas without access to high-quality microscopy. We aimed to evaluate whether RDT alone could rule out imported malaria in children presenting to UK emergency departments (EDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>UK-based, multi-center, retrospective, diagnostic accuracy study. Included: any child &amp;lt;16 years presenting to ED with history of fever and travel to a malaria-endemic country, between 01\/01\/2016 and 31\/12\/2017. Diagnosis: microscopy for malarial parasites (clinical reference standard) and RDT (index test). UK Health Research Authority approval: 20\/HRA\/1341.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 47 cases of malaria out of 1,414 eligible cases (prevalence 3.3%) in a cohort of children whose median age was 4 years (IQR 2\u20139), of whom 43% were female. Cases of Plasmodium falciparum totaled 36 (77%, prevalence 2.5%). The sensitivity of RDT alone to detect malaria infection due to any Plasmodium species was 93.6% (95% CI 82.5\u201398.7%), specificity 99.4% (95% CI 98.9\u201399.7%), positive predictive value 84.6% (95% CI 71.9\u201393.1%) and negative predictive value 99.8% (95% CI 99.4\u2013100.0%). Sensitivity of RDT to detect P. falciparum infection was 100% (90.3\u2013100%), specificity 98.8% (98.1\u201399.3%), positive predictive value 69.2% (54.9\u201381.2%, n = 46\/52) and negative predictive value 100% (99.7\u2013100%, n = 1,362\/1,362).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RDTs were 100% sensitive in detecting P. falciparum malaria. However, lower sensitivity for other malaria species and the rise of pfhrp2 and pfhrp3 (pfhrp2\/3) gene deletions in the P. falciparum parasite mandate the continued use of microscopy for diagnosing malaria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piad024","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T05:13:26Z","timestamp":1681794806000},"page":"290-297","source":"Crossref","is-referenced-by-count":3,"title":["A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK Emergency Departments"],"prefix":"10.1093","volume":"12","author":[{"given":"Chris","family":"Bird","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford , Oxford , UK"},{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust , Birmingham , 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