Evaluation of diagnostic accuracy of rapid diagnostic test for malaria diagnosis among febrile children in Calabar, Nigeria

Abstract

Background: The WHO recommends that all cases of suspected malaria should undergo parasitological test. Currently, the parasitological test comprises the rapid diagnostic test (RDT) or the microscopy. The performance of RDT in relation to microscopy is yet to be fully comprehended. Objectives: This study evaluated the diagnostic accuracy of RDT as against the diagnosis provided by microscopy in detecting malaria parasites among febrile under-5 children. Design: The study was a cross-sectional hospital-based design. Materials and Methods: Capillary blood samples were collected from 167 children who came to the hospital with a history of fever over a period of 6 months. The Paracheck-Pf RDT kit was used and its performance was compared with the gold standard, microscopy using thick film. Results: The prevalence of malaria infection was 41.9%. On comparing RDT with microscopy (microscopy assumed to be 100% sensitive and specific), RDT had a sensitivity of 51.4% and a specificity of 73.2%. The false-positive rate was 26.8% whereas the false-negative rate was 48.6%. The positive predictive value was 58.1% whereas the negative predictive value (NPV) was 67.6%. The RDT also had a positive likelihood ratio (LR) of 1.92 and a negative LR of 0.67. The RDT test accuracy was 64.1%. Conclusion: Malaria prevalence among febrile children was found to be high. The findings also suggest that inconsistencies in the performance of RDT kits may arise from many extraneous factors, and as such, they should not be used as a stand-alone test kit except a prior batch/lot validation test was carried on them.

Progress in Parasite Genomics and Its Application to Current Challenges in Malaria Control

“…The blood samples collected from patients must be lysed before the Plasmodium antigens being stained. RDT will indicate if the patient has malaria or not [38]. This diagnostic method is useful in rural areas as it is inexpensive and does not require expertise to perform the test [38].…”

“…RDT will indicate if the patient has malaria or not [38]. This diagnostic method is useful in rural areas as it is inexpensive and does not require expertise to perform the test [38]. There are various types of RDTs that can detect different antigens of Plasmodium parasites including P. falciparum and P. vivax,namelyP.…”

The use of dried tube specimens of Plasmodium falciparum in an external quality assessment programme to evaluate health worker performance for malaria rapid diagnostic testing in healthcare centres in Togo

“…Data from studies in the Democratic Republic of Congo have shown that only 18% of health workers correctly reported RDT results obtained as part of an external quality assurance (EQA) programme [3]. Unacceptably high false-positive and false-negative results from RDT use have been shown in other studies [4][5][6].…”

Selection and exploitation of prevalent, tandemly repeated genomic targets for improved real-time PCR-based detection of Wuchereria bancrofti and Plasmodium falciparum in mosquitoes

“…Currently, World Health Organization (WHO)-recommended methods for the detection of both malaria and lymphatic filariasis (LF) rely upon either the microscopic examination of blood samples or serological antigen/antibody testing [4][5][6]. While widely used and important for programmatic decision making processes [7][8][9], these approaches are dependent upon human blood sampling and considerable evidence exists demonstrating the potential for these testing methods to lead to both false-positive and false-negative results [6,[10][11][12]. While requiring more advanced infrastructure, DNA-based assays utilizing quantitative real-time polymerase chain reaction (qPCR), are able to improve upon diagnostic sensitivity and specificity of detection for these diseases [6,[13][14].…”