Evaluation of the Clinical Proficiency of RDTs, Microscopy and Nested PCR in the Diagnosis of Symptomatic Malaria in Ilorin, North-Central, Nigeria

Shittu, Olalere; Opeyemi, Olufunke Adenike; Ajibaye, Olusola; Omotesho, Babagbemi Olumuyiwa; Fakayode, Oluwatosin

doi:10.3889/oamjms.2018.218

Cited by 4 publications

(7 citation statements)

References 56 publications

(76 reference statements)

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“…The scores of the identification of P. vivax and P. ovale were quite low; the positive predictive value was only 51.60 and 28.95%. Morphological identification of P. vivax and P. ovale by microscopy has always been difficult, and requires rich experience and technical training from the technician ( 26 , 27 ). That's why, in this study, there were many misjudgments in the identification between the two.…”

Section: Discussionmentioning

confidence: 99%

“…The study also found that older technicians scored lower. Under normal circumstances, the technician's competency of plasmodium microscopy will increase with age; rich microscopy experience leads to better competence ( 13 , 26 , 35 ). However, there were no local malaria cases reported in Chongqing from 2011, and there were only about 30 imported cases each year in last decade.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Malaria Microscopy Competency at Primary Health Institutions in the Chongqing Municipality

Luo¹,

Zhou²,

Yi³

et al. 2021

Front. Med.

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Background: In April 2019, Chongqing passed the national malaria elimination assessment. However, around 30 imported malaria cases are still being reported every year, and Anopheles sinensis was widely distributed in Chongqing, meaning the risk of malaria resurgence still exists. Early diagnosis and treatment for malaria cases are effective measures to prevent malaria resurgence. The primary health institutions are the first station where potential malaria cases may seek treatment. The competency with which primary health institutions diagnose malaria will directly affect the timeliness of malaria diagnosis. Nowadays, most primary health institutions in Chongqing use microscopy to confirm malaria cases. This study assessed the microscopy competence of primary health institutions, studied and analyzed the results, and provided a scientific basis for malaria prevention and control after malaria elimination in Chongqing.Methods: According to the stratified sampling principle, four plasmodium microscopy technicians (156 in total) were selected from each of the 39 districts/counties of Chongqing to test the plasmodium microscopy competence. Descriptive statistical analysis, correlation analysis, spatial self-correlation analysis, and ROC curve analysis were carried out on the test results.Result: The average of the technicians' test scores was 4.33 ± 0.47 (min: 3, mid: 4.5, max: 5); The spatial clustering of the scores was significant (MoranI = 0.338, Z = 3.618, P < 0.01). The test scores were positively correlated with the “level of work institutions” (R = 0.21, P < 0.01) but were negatively correlated with “age” (R = −0.31, P < 0.01). The highest Sensitivity of the technicians' microscopy was in qualitative diagnosis (98.92%, CI: 98.00–99.69%). The Delong's test showed that the diagnostic efficiency of the technicians' microscopy to P. falciparum was the best (P < 0.01), however to P. ovale was the worst (P < 0.01).Conclusion: The microscopy technicians in primary health institutions in Chongqing have good microscopy competency in qualitative diagnosis, but there were deficiencies in the identification of plasmodium species. Township level health institutions in Central China have weaker microscopy than those in other areas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of Malaria Microscopy Competency at Primary Health Institutions in the Chongqing Municipality

Luo¹,

Zhou²,

Yi³

et al. 2021

Front. Med.

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“…In order to employ them for the nested PCR, already-existing primers that target the 18S rRNA of Plasmodium species were changed in cycling conditions (nPCR). Isolated gDNA and the primary amplicon, respectively, were employed for the PCR amplification in the primary and nested PCRs [15].The highly sensitive nested PCR is commonly used for microscopy accuracy assessment, epidemiological research, diagnosis confirmation, and pharmaceutical efficacy evaluation. The high cost, complexity, material requirements, and strenuous exercise requirements of nPCR techniques may prevent many resource-poor populations from finding them to be a suitable diagnostic tool [14].…”

Section: Nested Pcr (Npcr)mentioning

confidence: 99%

“…However, in locations with limited resources, such tools are not readily available, and in endemic populations, the need for a skilled technician, quality control, and equipment maintenance may be "far-reached." It is concerning to see that qPCR has a high proportion of false positive results [15].…”

Section: Quantitative Pcr (Qpcr)mentioning

confidence: 99%

Diagnosis and Treatment of Malaria in Nigeria

Chen¹,

Fang²,

Li³

et al. 2022

HSET

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There are 241 million malaria cases in 2020 globally based on WHO’s “World Malaria Report 2021”, Nigeria is the hardest hit region. The mechanism of the parasite caused many complications and the two hosts of the transmission. The malaria parasite is transmitted from the salivary glands of the mosquito to the human blood. Once the parasite was transmitted to the human, it can cause a human to human transmission through the contacting with the infected blood. Mainstream diagnostic techniques of Malaria includes Malaria Rapid Diagnostic Testing (RDT) / Histidine-rich Protein 2(HRP2) MRDT/Paracheck-Pf RDT; microscopy; nested PCR (nPCR) ; quantitative PCR (qPCR) . There are also advanced diagnostic technologies such as Loop-mediated Isothermal Amplification (LAMP) and CRISPR-based Diagnostic-using the nucleic acid detection platform Sherlock (specific high-sensitivity enzymatic reporter unlocking) . Nowadays in Nigeria, despite the decreased drug sensitivity against the disease, new methods and drugs have emerged in a bid to control this parasitic infection. The treatment continues to change and more discoveries have been made on how to treat the disease. This paper summarizes the status quo of malaria in Nigeria and provides possible and effective ways for Nigeria to eliminate malaria.

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“…Other studies obtained in Nigeria had obtained different sensitivity and specificity. Ogbolu and others obtained a sensitivity and specificity of 29.4% and 100% in a study in Ile-Ife[27] in south western Nigeria, Kanyi and others 53.8% and 100% in Lagos [28] and Waggoner et al obtained 97.1% and 93.5% also in Lagos[39]. It has been estimated that a diagnostic test with 95% sensitivity and 95% specificity requiring minimal infrastructure would avert more than 100,000 deaths and about 400 million unnecessary treatments[40].…”

mentioning

confidence: 99%

Usefulness of Polymerase Chain Reaction in the diagnosis of asymptomatic malaria among school age children in Ilorin, Nigeria

Adedoja

Babatunde²,

Tijani

et al. 2018

PAJOLS

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Introduction: In Nigeria, microscopy and Rapid Diagnostic Tests (RDTs) are majorly used routinely to diagnose malaria in clinical settings. In recent years, molecular diagnosis has emerged as the most sensitive method for malaria diagnosis. This study determined the usefulness of Polymerase Chain Reaction (PCR) in comparison to microscopy (Giemsa stained thick and thin smears) for the diagnosis of asymptomatic malaria in Ilorin, Nigeria. Methods: Th e study enrolled 310 school children aged 4–15 years with no sign or symptoms of malaria. Blood samples were collected for identification of Plasmodium species infection using light microscopy and conventional PCR. Results: The PCR method detected m o r e infection of P. falciparum 107 (34.5%) than slide microscopy 81 (26.1%) in the study. Only P. falciparum was detected by microscopy while PCR detected mono infection of P. malariae (3.2%) and P. ovale (0.6%) and mixed infection of P. falciparum and P. malariae (3.2%). Overall the PCR method detected more malaria parasite compared to microscopy. Conclusion: The PCR technique, although more laborious and expensive than microscopy, have better diagnostic accuracy and are highly useful for the detection of P. falciparum and other malaria species in asymptomatic and low parasitaemia cases.

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Evaluation of the Clinical Proficiency of RDTs, Microscopy and Nested PCR in the Diagnosis of Symptomatic Malaria in Ilorin, North-Central, Nigeria

Cited by 4 publications

References 56 publications

Assessment of Malaria Microscopy Competency at Primary Health Institutions in the Chongqing Municipality

Assessment of Malaria Microscopy Competency at Primary Health Institutions in the Chongqing Municipality

Diagnosis and Treatment of Malaria in Nigeria

Usefulness of Polymerase Chain Reaction in the diagnosis of asymptomatic malaria among school age children in Ilorin, Nigeria

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