Comparative Assessment of Microscopy and Rapid Diagnostic Test (RDT) as Malaria Diagnostic Tools

Malaria presents a diagnostic challenge in most tropical countries such as Rwanda. Microscopy remains the gold standard for diagnosing malaria, but it is labor intensive and depends upon the skill of the examiner. Malaria rapid diagnostic tests (RDTs) have been developed as an easy, convenient alternative to microscopy. is cross-sectional study was conducted at Rukara Health Center which is located in Eastern Province, Kayonza district, Rwanda. One hundred and fifty suspected cases of malaria, who attended Rukara Health Centre, during the period, from 21 st June to 30th July 2018, were included in this study. HRP-2 RDTs (CareStart ™ Malaria HRP-2 (Access Bio, Inc., Somerset, New Jersey, USA)), for malaria were performed. ick smears were prepared and Giemsa-stained as recommended; then slides were observed under microscopy and reported quantitatively; RDTs were reported qualitatively (positive or negative). Both RDTs and thick smear results were recorded on data collection sheet. is study included a total of 150 study participants, 87 (58%) females and 63 (42%) males. e patients included in the study did not receive any antimalarial drug. e mean age of the study participants was 31.6 ± 12.4 with the majority of participants being between 25 and 44 years and the minority being above 65 years. e sensitivity of RDT (HRP-2) was calculated and found to be 95.0%, whereas the sensitivity of Giemsa microscopy was 100%. e specificity of RDT (HRP-2) was calculated and found to be 59.2%, whereas the specificity of Giemsa microscopy was 100%. Negative and positive predictive values of RDT are 85.4% and 82.7%, respectively. Negative and positive predictive values of Giemsa microscopy were both 100%. According to the results of the current study, the sensitivity, specificity, and both positive and negative predictive values of Giemsa microscopy are higher than those of histidine-rich protein 2-based rapid diagnostic test for malaria. e results obtained in histidine-rich protein 2-based rapid diagnostic test for malaria parasites should be confirmed with tests with high specificity. Further studies should determine the most appropriate type of rapid diagnostic test of malaria diagnosis to be used in combination with Giemsa microscopy. In addition, sensitivity and specificity of RDT (HRP-2) and Giemsa microscopy should be assessed against molecular biology techniques.

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“…is conventional staining of peripheral blood smears/microscopy, however, still remains the gold standard in laboratory diagnosis of malaria [4].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance between Histidine-Rich Protein 2 (HRP-2), a Rapid Malaria Diagnostic Test and Microscopic-Based Staining Techniques for Diagnosis of Malaria

Niyibizi

Gatera

2020

Journal of Tropical Medicine

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“…33 The study found a specificity of 100% for RDT, comparable with findings from other past studies. 29,31,32 The study further demonstrated a PPV of 1 (100%) and an NPV of 0.6 (60%). The PPV as found by this study is comparable to what had been reported by.…”

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confidence: 78%

“…The PPV as found by this study is comparable to what had been reported by. 29,31 However, much lower values were reported by. 30,32 Comparatively low NPVs were reported by.…”

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confidence: 83%

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Rapid diagnostic test versus microscopy in the diagnosis of acute malaria in a district hospital in Enugu state, Southeast Nigeria

Umegbolu¹,

Madukwe²

2017

Int J Community Med Public Health

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Background: Malaria is a systemic disease caused by various species of Plasmodium, transmitted through the bite of a female Anopheles mosquito. According to the World Health Organisation, there were 214 million cases of malaria worldwide in 2015. Nigeria’s burden of malaria is about 51million cases and 207,000 deaths annually, accounting for 60% of outpatient visits to hospitals, 11% of maternal mortality, and 30% of child mortality. The study aimed to compare RDT and microscopy in malaria diagnosis in a District Hospital in Enugu state, Southeast Nigeria. Methods: Blood samples of 300 suspected cases of acute malaria were tested for malaria parasite using RDT and microscopy simultaneously. Results: In 2017, the study found a malaria prevalence of 25% (46.2% in children, and 18.1% in adults) in Awgu. RDT was positive in 38% and microscopy in 70.3% of cases. Both RDT and microscopy were positive in 36.3%, negative in 28.3%, and discordant in 35.4%. Sensitivity of RDT was 50.7% (89.4% in children, and 25.6% in adults). RDT had a specificity of 100% (both children and adults), positive predictive value of 1 (both children and adults), and negative predictive value of 0.6 (0.5 in children, 0.6 in adults). Conclusions: RDT (SD Malaria Ag P. f) had more sensitivity in children (89.4%) than adults (25.6%), and the occurrence of false negative results was more in adults (46.8%) than children (9.5%). All negative RDT results need to be examined microscopically, to rule out false negative cases.

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“…Ayogu E E 18 concluded that Rapid diagnostic tests could be useful in areas with high parasite density as an alternative to smear microscopy with the sensitivity and specificity PPV and NPV of RDT 82.2%, 100.0%, 100.0%, and 34.3%, respectively. Oyetunde T et al 19 in their study considering microscopy as the gold standard, RDT exhibited high specificity 87.1% and low sensitivity 42.5% with positive predictive and negative predictive values of 86.6 and 43.5%, respectively. Jaswinder Sharma et al 20 concluded in their study that the sensitivity of RDT is 97.4%, specificity 100% when compared to microscopy.…”

Section: Comparison Of Smear Microscopy and Rapid Diagnosticmentioning

confidence: 93%

Evaluation of Rapid Diagnostic Tests for Early Diagnosis of Malaria in Rural India to Prevent Deadly Complications

V.S¹,

Sindhura²,

M.N³

2019

jemds

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A B S T R A C T BACKGROUNDAs per World Malaria Report, 2018, There were an estimated 219 million cases and 435000 related deaths in 2017, with about 9.5 million malaria cases and 16,733 related deaths in 2017 in India. The most severe clinical form of malaria is caused by P. falciparum infection. The disease is usually fatal in non-immunes. The complications of falciparum malaria are cerebral malaria, pulmonary oedema, septicaemia and shock. If these complications are not diagnosed early and are not treated adequately, the patient becomes fatal. To prevent these complications, we need early diagnosis. Clinical diagnosis of malaria requires microscopic detection of the parasite. Diagnosis of malaria by microscopy is the gold standard but requires expertise and is time consuming. Recently, new rapid malaria detection tests based on detection of an enzyme produced by live parasites, parasite lactate dehydrogenase (pLDH) and Histidine Rich Proteins (HRPII) have been developed. It is simple, easy to use and does not require expertise. In the present study, the Rapid Diagnostic Tests are evaluated for the effectiveness for early diagnosis of Malaria in Rural India to prevent deadly complications. METHODSThe study, conducted in a hospital, included 733 patients with fever of 3 days duration after obtaining consent from the subjects and approval from the ethical committee. 733 whole blood samples were collected and tested for Smear Microscopy for Malarial parasites and were also tested with Rapid Diagnostic Tests. The study was spread over 10 months from June, 2018 to March, 2019 and results were sent for analysis. Rapid Diagnostic Test (RDT) was compared with 'Gold Standard' technique i.e.; Microscopy-Smear Examination with the help of X 2 values, sensitivity, specificity, positive predictive values, negative predictive values, percentage of false negatives, percentage of false positives, positive likelihood ratio(LR+), and negative likelihood ratio (LR-) values. RESULTSThe results of Rapid Diagnostic Test (RDT) were compared with smear microscopy and it was found that RDT is as effective as Smear Microscopy in diagnosing Malaria with 97.81% sensitivity, 97.82% specificity, 97.20% Positive predictive value and 98.30% Negative predictive value. In diagnosing the species of Malaria also, RDT is found to be as effective as Smear Microscopy in differentiating Falciparum Malaria with 97.98% sensitivity value, 98.79% specificity value, 97.49% positive predictive value, 99.03% negative predictive value. RDT is found to be as effective as Smear Microscopy in differentiating Vivax Malaria with 97.54% sensitivity, 99.03% specificity, 96.75% positive predictive value and 99.27% negative predictive value. CONCLUSIONSThe present study concludes Rapid Diagnostic Tests are effective screening tests as shown by the high sensitivity, specificity and predictive values, high Likelihood positive(LR+) and low Likelihood Negative(LR-) values.

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Comparative Assessment of Microscopy and Rapid Diagnostic Test (RDT) as Malaria Diagnostic Tools

Cited by 16 publications

References 21 publications

Diagnostic Performance between Histidine-Rich Protein 2 (HRP-2), a Rapid Malaria Diagnostic Test and Microscopic-Based Staining Techniques for Diagnosis of Malaria

Diagnostic Performance between Histidine-Rich Protein 2 (HRP-2), a Rapid Malaria Diagnostic Test and Microscopic-Based Staining Techniques for Diagnosis of Malaria

Rapid diagnostic test versus microscopy in the diagnosis of acute malaria in a district hospital in Enugu state, Southeast Nigeria

Evaluation of Rapid Diagnostic Tests for Early Diagnosis of Malaria in Rural India to Prevent Deadly Complications

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