# Estimating the incremental benefits on active malaria case detection of high-sensitivity rapid diagnostic tests

> **NIH NIH R03** · DUKE UNIVERSITY · 2020 · $80,500

## Abstract

Project Abstract
Malaria control is reducing parasite transmission in many parts of sub-Saharan Africa, which enables the
application of more aggressive control measures. Among these are active case detection (ACD), in which
community members are screened with diagnostic tests, and reactive case detection (RACD), a strategy in
which passively-detected cases trigger “ring screening” with diagnostic testing in order to identify secondary
cases. RACD is described by WHO’s Framework for Malaria Elimination as “an important component of an
elimination strategy.” RACD has been considered infeasible in many African settings owing to a lack of spatial
case aggregation, limits in operational capacity, and the inability to detect low-density infections (< 100
parasites/µL [p/µL]) with malaria rapid diagnostic tests (RDTs). Importantly, next-generation RDTs are enabling
detection of parasites to very low densities (~ 1 p/µL), suggesting that, coupled with declines in transmission,
RACD with RDTs may become an efficient strategy for case detection in many African settings. What we do
not know are the predicted impacts of a next-generation RDT for RACD on both the incremental gains in
secondary case detection as well as on the case detection rate compared with standard ACD. In this R03
project, we will use previously-collected specimens from a study conducted in 2014 in Webuye, Kenya, which
has seasonal, perennial transmission of P falciparum; the study enrolled children both with and without clinical
malaria (assessed by standard RDT) as index cases and then sampled all members of their households for a
dried blood spot. In > 4,000 individuals sampled, we will detect P. falciparum using a real-time PCR assay
targeting a multi-copy gene target that can detect parasites down to 0.1 p/µL and quantify down to 1 p/µL. In
Aim 1, we will use molecular parasite density measurements to estimate the marginal yield of detected
parasites by RACD programs employing RDTs with limits of detection that vary from 200 to 1 p/µL. In Aim 2,
we will compare between ACD and RACD the incremental secondary case detection rate that would have
been detected by a next-generation RDT with a limit of detection of 1 p/µL. Our data will enable the rational
design of implementation studies that test the use of next-generation RDTs as tools for RACD in Africa. These
studies will ultimately furnish an evidence base for the deployment of RACD more widely as a public health
activity as African countries continue to push towards malaria elimination.

## Key facts

- **NIH application ID:** 9974475
- **Project number:** 5R03AI146406-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Steve Myer Taylor
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $80,500
- **Award type:** 5
- **Project period:** 2019-07-08 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9974475

## Citation

> US National Institutes of Health, RePORTER application 9974475, Estimating the incremental benefits on active malaria case detection of high-sensitivity rapid diagnostic tests (5R03AI146406-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9974475. Licensed CC0.

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