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. 2011 Jul 6;2011(7):CD008122. doi: 10.1002/14651858.CD008122.pub2

Sharew 2009.

Clinical features and settings Presenting signs and symptoms: Febrile patients, clinically suspected for malaria
Previous treatment for malaria: No exclusions based on previous treatment. Information on previous treatment collected, but actual data not provided.
Clinical setting: Outpatient departments of two health centres
Country: Ethiopia (Southern ‐ Wondo Genet)
Malaria endemicity: Takes place throughout the year
Malaria endemic species:P. falciparum and P. vivax
Participants Sample size: 668
Age: All age groups eligible. Actual age range 6 months to 75 years.
Sex: 361 (54%) males, 307 (46%) females
Co‐morbidities and pregnancy: No exclusion criteria based on co‐morbidities or pregnancy. No details of the frequency of these conditions in the participant population is presented.
Parasite density of microscopy positive cases: Not presented
Study design Enrollment was consecutive and prospective. Two different RDTs were evaluated, and each participant received both tests.
Target condition and reference standard(s) Target condition: Malaria parasitaemia
Reference standard: Microscopy thick and thin blood films
Person(s) performing microscopy: Experienced malaria technicians
Microscopy setting: Not stated, but in the Wondo Genet area
Number of high power fields examined before declaring negative: 100
Number of observer or repeats: Two independent technicians, also checked by the team leader
Resolution of discrepancies between observers: All discordant results between microscopy and RDTs were repeated
Index and comparator tests Commerical name of RDT:
Paracheck Pf (Orchid Biomedical Systems, Goa, India)
CareStart Malaria Pf/Pv Combo test (Access Bio Inc., New Jersey, USA)
Parasite(s) designed to detect:P. falciparum
Paracheck Pf ‐ P. falciparum
CareStart Malaria Pf/Pv Combo test ‐ P. falciparum, P. vivax or mixed infection
Designated Type:
Paracheck Pf ‐ Type 1
CareStart Malaria Pf/Pv Combo test ‐ Type 5
Batch numbers: Not stated
Transport and storage conditions: As per the instructions of the manufacturer
Person(s) performing RDT: Not stated
RDT setting: Two health centres
Follow‐up Not applicable
Notes Source of funding: School of Graduate Studies of the Addis Adaba University through the Graduate Programme in Tropical and Infectious Diseases, Aklilu Lemma Institute of Pathobiology and from the Federal Ministry of Health of Ethiopia. Federal Ministry of Health of Ethiopia and Access Bio Inc. donated the test kits.
Table of Methodological Quality
Item Authors' judgement Description
Representative spectrum? 
 All tests Yes Participants were a consecutive sample of febrile patients attending health centres with suspected malaria
Acceptable reference standard? 
 All tests Yes Two experienced microscopists independently viewed 100 high power fields before declaring a slide negative
Partial verification avoided? 
 All tests Yes All participants who received the index test also received the reference test
Differential verification avoided? 
 All tests Yes The same reference test was used regardless of the index test results
Incorporation avoided? 
 All tests Yes The index test does not form part of the reference standard
Reference standard results blinded? 
 All tests Unclear Not described
Index test results blinded? 
 All tests Yes Strict blinding with the results available before microscopy reported
Uninterpretable results reported? 
 All tests Yes If a test was uninterpretable then it was repeated
Withdrawals explained? 
 All tests Yes The number of participants enrolled in the study was clearly stated and corresponds to the number included in the analysis; therefore there were no withdrawals