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This study aimed to compare the diagnostic performance of the\n                      <jats:italic>Pf<\/jats:italic>\n                      HRP2-based Abbott Malaria Ag\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      ultrasensitive RDT (uRDT) to that of the conventional SD-Bioline Malaria Ag\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      RDT (cRDT) when performed under field conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Finger-prick blood samples were collected from adults and children in two cross-sectional surveys in May of 2017 in southern Mozambique. Using real-time quantitative PCR (RT-qPCR) as the reference method, the age-specific diagnostic performance indicators of the cRDT and uRDT were compared. The presence of histidine-rich protein 2 (HRP2) and\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      lactate dehydrogenase (pLDH) antigens was evaluated in a subset from dried blood spots by a quantitative antigen assay.\n                      <jats:italic>pfhrp2<\/jats:italic>\n                      and\n                      <jats:italic>pfhrp3<\/jats:italic>\n                      gene deletions were assessed in samples positive by RT-qPCR and negative by both RDTs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 4,396 participants with complete test results, the sensitivity of uRDTs (68.2; 95% CI 60.8 to 74.9) was marginally better than that of cRDTs (61.5; 95% CI 53.9 to 68.6) (p-value\u2009=\u20090.004), while the specificities were similar (uRDT: 99.0 [95% CI 98.6 to 99.2], cRDT: 99.2 [95% CI 98.9 to 99.4], p-value\u2009=\u20090.02). While the performance of both RDTs was lowest in\u2009\u2265\u200915-year-olds, driven by the higher prevalence of low parasite density infections in this group, the sensitivity of uRDTs was significantly higher in this age group (54.9, 95% CI 40.3 to 68.9) compared to the sensitivity of cRDTs (39.2, 95% CI 25.8 to 53.9) (p-value\u2009=\u20090.008). Both RDTs detected\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      infections at similar geometric mean parasite densities (112.9\u00a0\u00a0parasites\/\u03bcL for uRDTs and 145.5\u00a0parasites\/\u03bcL for cRDTs). The presence of HRP2 antigen was similar among false positive (FP) samples of both tests (80.5% among uRDT-FPs and 84.4% among cRDT-FPs). Only one false negative sample was detected with a partial\n                      <jats:italic>pfhrp2<\/jats:italic>\n                      deletion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study showed that the uRDTs developed by Abbott do not substantially outperform SD-Bioline\n                      <jats:italic>Pf<\/jats:italic>\n                      malaria RDTs in the community and are still not comparable to molecular methods to detect\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      infections in this study setting.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-020-03526-9","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T06:04:02Z","timestamp":1607321042000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Field performance of ultrasensitive and conventional malaria rapid diagnostic tests in southern Mozambique"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9546-6385","authenticated-orcid":false,"given":"Beatriz","family":"Galatas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Mayor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himanshu","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Balanza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihn Kyung","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Nhamussua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Simone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"Cister\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlindo","family":"Chidimatembue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humberto","family":"Munguambe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Sa\u00fate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Aide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"3526_CR1","volume-title":"World Malaria Report 2019","author":"WHO","year":"2019","unstructured":"WHO. 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