Table 3.
Modelled sensitivity of diagnostic tests
| Sensitivity (95% CI) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10 p/μL | 50 p/μL | 100 p/μL | 200 p/μL | 10 p/μL | 50 p/μL | 100 p/μL | 200 p/μL | 10 p/μL | 50 p/μL | 100 p/μL | 200 p/μL | |
| A. Overall modelled sensitivities at low density | B. Modelled sensitivity by fever status | |||||||||||
| Overall | Febrile | Afebrile | ||||||||||
| Microscopy | 7% (4–15) | 45% (34–57) | 69% (54–81) | 86% (72–93) | 11% (2–38) | 71% (48–87) | 90% (67–98) | 97% (79–100) | 6% (2–14) | 34% (22–47) | 56% (38–72) | 76% (55–89) |
| cRDT | 26% (18–36) | 56% (46–66) | 69% (56–80) | 80% (66–89) | 48% (26–71) | 84% (64–94) | 91% (71–98) | 96% (76–99) | 20% (12–30) | 44% (32–56) | 56% (40–71) | 68% (48–83) |
| usRDT | 32% (24–43) | 62% (51–71) | 73% (60–83) | 82% (68–91) | 51% (29–73) | 81% (62–92) | 89% (68–97) | 94% (72–99) | 27% (19–39) | 52% (40–64) | 63% (48–77) | 73% (54–87) |
| LAMP | 55% (45–64) | 74% (64–82) | 80% (69–88) | 86% (73–93) | 58% (35–78) | 87% (68–96) | 93% (73–99) | 96% (77–100) | 53% (42–64) | 68% (56–78) | 73% (58–85) | 78% (60–90) |
| C. Modelled sensitivity by gravidity | ||||||||||||
| Primigravid | Secundigravid | Multigravid | ||||||||||
| Microscopy | 10% (3–29) | 47% (30–65) | 69% (45–86) | 85% (56–96) | 7% (2–27) | 49% (27–71) | 74% (47–90) | 90% (63–98) | 7% (2–19) | 39% (22–59) | 62% (37–83) | 81% (51–95) |
| cRDT | 34% (17–57) | 59% (42–74) | 69% (47–84) | 77% (50–92) | 24% (11–44) | 55% (36–73) | 69% (45–86) | 80% (52–93) | 23% (13–37) | 55% (36–72) | 69% (45–86) | 80% (53–94) |
| usRDT | 46% (26–68) | 67% (51–81) | 75% (54–89) | 81% (55–94) | 35% (20–54) | 61% (42–77) | 72% (48–87) | 80% (53–94) | 25% (14–39) | 56% (38–73) | 70% (46–86) | 81% (53–94) |
| LAMP | 56% (33–76) | 77% (60–88) | 83% (62–94) | 88% (63–97) | 67% (48–81) | 81% (62–92) | 86% (63–95) | 89% (63–98) | 47% (33–60) | 65% (48–80) | 72% (50–87) | 79% (51–93) |
| D. Modelled sensitivity by trimester of pregnancy | ||||||||||||
| First | Second | Third | ||||||||||
| Microscopy | 7% (2–27) | 39% (18–64) | 61% (30–85) | 80% (40–96) | 5% (2–14) | 48% (32–64) | 76% (56–88) | 91% (75–97) | 20% (6–51) | 45% (23–68) | 57% (27–82) | 69% (29–92) |
| cRDT | 15% (5–37) | 48% (26–70) | 65% (35–87) | 79% (42–95) | 24% (14–36) | 62% (48–75) | 77% (60–88) | 87% (71–95) | 51% (27–75) | 49% (28–71) | 48% (22–76) | 47% (16–81) |
| usRDT | 28% (13–51) | 56% (34–76) | 68% (39–88) | 78% (42–95) | 29% (19–43) | 69% (54–80) | 82% (66–91) | 90% (75–97) | 51% (27–75) | 49% (28–71) | 48% (22–76) | 47% (16–81) |
| LAMP | 61% (39–79) | 86% (59–96) | 91% (60–99) | 95% (60–100) | 53% (41–65) | 76% (63–85) | 83% (68–92) | 88% (72–96) | 52% (27–76) | 56% (33–77) | 58% (29–82) | 60% (23–88) |
Diagnostic test sensitivity at low density derived from logistic models incorporating PET-PCR samples with parasite densities below 500 parasites/μL. (A) Overall modelled sensitivity of diagnostic tests at low density, (B) modelled sensitivity by fever status, (C) by gravidity, and (D) by trimester of pregnancy. Abbreviations: 95% CI, 95% confidence interval; p/μL, parasites per microliter; cRDT, conventional RDT; usRDT, ultra-sensitive RDT; LAMP, loop-mediated isothermal amplification.