Considerations for quality assurance of multiplex malaria antigen detection assays with large sample sets

Sci Rep. 2021 Jun 24;11(1):13248. doi: 10.1038/s41598-021-92723-w.

Abstract

Multiplex assays for malaria antigen detection can gather data from large sample sets, but considerations for the consistency and quality assurance (QA) of mass testing lack evaluation. We present a QA framework for a study occurring November 2019 to March 2020 involving 504 assay plates detecting four Plasmodium antigens: pan-Plasmodium aldolase and lactate dehydrogenase (LDH), histidine-rich protein 2 (HRP2), P. vivax LDH (PvLDH). Controls on each plate included buffer blank, antigen negative blood, and 4-point positive dilution curve. The blank and negative blood provided consistently low signal for all targets except for pAldolase, which showed variability. Positive curve signals decreased throughout the 5-month study duration but retained a coefficient of variation (CV) of < 5%, with the exception of HRP2 in month 5 (CV of 11%). Regression fittings for inter-plate control signals provided mean and standard deviations (SDs), and of 504 assay plates, 6 (1.2%) violated the acceptable deviation limits and were repeated. For the 40,272 human blood samples assayed in this study, of 161,088 potential data points (each sample × 4 antigens), 160,641 (99.7%) successfully passed quality checks. The QA framework presented here can be utilized to ensure quality of laboratory antigen detection for large sample sets.

MeSH terms

  • Adolescent
  • Antigens, Protozoan / blood
  • Antigens, Protozoan / immunology*
  • Child
  • Fructose-Bisphosphate Aldolase / immunology
  • Humans
  • L-Lactate Dehydrogenase / immunology
  • Malaria / immunology*
  • Nigeria
  • Plasmodium / immunology*
  • Protozoan Proteins / immunology
  • Quality Control
  • Serologic Tests / methods

Substances

  • Antigens, Protozoan
  • HRP-2 antigen, Plasmodium falciparum
  • Protozoan Proteins
  • L-Lactate Dehydrogenase
  • Fructose-Bisphosphate Aldolase