Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age

Ajumobi, Olufemi; Sabitu, Kabir; Nguku, Patrick; Kwaga, J. K. P.; Ntadom, Godwin; Gitta, Sheba; Rutebemberwa, Elizeus; Oyibo, Wellington; Nsubuga, Peter; Maire, Mark; Poggensee, Gabriele

doi:10.4269/ajtmh.13-0558

Cited by 35 publications

(40 citation statements)

References 24 publications

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“…J. Parasitol., 10 (3): 120-126, 2015 The sensitivity of RDT reported in this study is lower than previous reports in Nigeria (Ajumobi et al, 2015) and other parts of the world. Sensitivities of 96, 97 and 97.6% had been reported in Zambia, Zanzibar and Thailand, respectively (Hopkins et al, 2008;Msellem et al, 2009;Nicastri et al, 2009).…”

Section: Discussioncontrasting

confidence: 55%

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

Oyeyemi¹,

Ogunlade²,

Oyewole³

2015

Research J. of Parasitology

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Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The aim of this study was to compare the effectiveness of RDT and microscopy in detection of malaria parasite in a malaria endemic area of Nigeria among different population groups. The cross sectional study was conducted on 251 febrile patients who were directed to the laboratory department for blood screening for malaria parasites at Ogunlade Hospital, Ijebu Ode, Ogun state. Blood samples were collected and screened for malaria parasites microscopically and by using First Response RDT. The prevalence of malaria obtained through microscopy (66.8%) was significantly higher than in RDT (36.8%) (p<0.05). 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. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia (p<0.0001). The routine microscopy test demonstrated a superior sensitivity compared to First Response RDT method of malaria diagnosis, however, RDT could be a useful tool in individuals suspected to show high degree of disease spectrum for quick intervention in order to avert danger associated with delayed diagnosis.

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Section: Discussioncontrasting

confidence: 55%

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

Oyeyemi¹,

Ogunlade²,

Oyewole³

2015

Research J. of Parasitology

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“…The specificity of 99.6% found in this study is higher than 93%, 88%, 98.5% and 92.7%% reported by Buchachart et al (2004); Msellem et al (2009);Ajumobi et al (2015) and Osei-Yeboah et al (2016) but less than the 100% reported by Dougnon et al (2015). This means that the probability of the RDT to detect negative cases among those that are negative with smear microscopy is as high as 99.6% and therefore prevent unnecessary treatment of those who are not having the parasite but only those with the parasite.…”

Section: Discussioncontrasting

confidence: 53%

“…The sensitivity of the RDT of 94.0% reported in this study is lower than 96%, 97%, 97.6% and 100% reported by Hopkins et al, (2008); Msellem et al (2009);Nicastri et al (2009) and Ajumobi et al (2015) but higher than the 62.5% reported by Osei-Yeboah et al (2016) in studies within and outside Nigeria. This means that the probability of the RDT to detect positive cases among those that are positive with smear microscopy is as high as 94.0%.…”

Section: Discussioncontrasting

confidence: 50%

A comparison of microscopic and rapid diagnostic test methods for diagnosis of malaria parasite.

Omo-Emmanuel¹,

Ochei²,

Donald³

et al. 2017

Int. J. Adv. Multidiscip. Res.

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Early and accurate diagnosis of febrile patients is essential for the proper treatment of uncomplicated malaria and prevention of severe malaria. This necessitated the introduction of rapid diagnostic tests (RDTs) for malaria for patients in endemic regions with poor power supply and shortage of qualified manpower required for microscopy. However, there is very little evidence to guide decision-makers on the sensitivity and specificity of these RDTs. Therefore, the aim of this study was to compare the use of microscopy and RDTs in the diagnosis of malaria parasite. The hospital-based retrospective study was conducted by reviewing laboratory registers and records of 387 patients with febrile illness lasting for 1-3 days who were clinically diagnosed of malaria fever and sent to the laboratory for confirmation. The overall prevalence of malaria parasite with smear microscopy of 39.3% was higher than in RDT test 37.0% but there was no significant difference between smear microscopy and RDT test results (P=0.685). This study found a low proportion of false positive and negative test results with the RDT, which is a characteristic of a test method that can give a quality result. Using smear microscopy as the gold standard, RDT was found to have a sensitivity of 94.0% and specificity of 99.6% with positive predictive and negative predictive values of 99.3% and 96.3% respectively. The sensitivity of RDT test was higher in males (93.8%) than in females (93.2%) but there was no significant difference between the two genders (P=0.819). The mean age of participants with negative RDT results (32.68) was significantly higher than those with RDT positive result (20.50) (P<0.0001). The highest sensitivity of the RDT (97.4%) was in those under 18 years. However, there were no significant differences among the different age groups (p<0.05). Similarly, the mean PCV of participants with negative RDT results (32.07) was significantly higher than those with RDT positive result (28.15) (P<0.0001). Antigen-based malaria RDT is as reliable as smear microscopy for the diagnosis of malaria parasite in malaria endemic areas.

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“…Studies have shown that persistent antigenemia detectable by HRP2-based RDTs occurs in 10% of patients [5]. False-negative results also occur and have more serious consequences because patients who have parasites are not detected and may be given inappropriate treatment; this phenomenon has been noted with HRP2 tests in the presence of low- and high-level parasitemia [6, 7] . Hence, the single most intractable problem with use of RDTs is trust in and compliance with RDT-negative results, particularly if the patient could have been treated to resolve the illness.…”

mentioning

confidence: 99%

Compliance With Malaria Rapid Diagnostic Testing by Community Health Workers in 3 Malaria-Endemic Countries of Sub-Saharan Africa: An Observational Study

Singlovic¹,

Ajayi²,

Nsungwa-Sabiiti³

et al. 2016

Clin Infect Dis.

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Background. The World Health Organization recommends that all malaria management be based on parasitological identification. We monitored performance of trained community health workers (CHWs) in adhering to this recommendation to restrict artemisinin-based combination therapies (ACTs) to positive rapid diagnostic test (RDT)–confirmed cases in children in 3 malaria-endemic sub-Saharan African countries.Methods. In 33 villages in Burkina Faso, 45 villages in Nigeria, and 84 villages in Uganda, 265 CHWs were trained over a minimum of 3 days to diagnose malaria using RDTs (prepare, read, record results, and inform the patient about results) and treat RDT-confirmed uncomplicated malaria cases with ACTs. In Nigeria, CHWs were also taught to obtain a thick blood smear. Spent RDT kits and prepared blood slides were collected and interpreted independently in Burkina Faso and Nigeria to confirm CHWs' diagnoses. Interviews were held with 12 of 17 CHWs who prescribed ACTs for patients with RDT-negative test results, and with 16 of 29 caregivers to determine factors related to noncompliance.Results. Of 12 656 patients treated with ACTs in the participating countries (5365 in Burkina Faso, 1648 in Nigeria, and 5643 in Uganda), 29 patients (8 from Burkina Faso, 17 from Nigeria, 4 from Uganda) were RDT negative. The small number of RDT-negative ACT-treated cases limits statistical analysis. Only a few CHWs were involved, and they were more likely to be traders rather than farmers (odds ratio [OR], 6.15; 95% confidence interval [CI], 2.09–18.07; P = .0004). RDT-negative children who were treated with ACTs had a significantly higher probability of residing in a village other than that of the CHW (OR, 3.85; 95% CI, 1.59–9.30; P = .0018). Parental pressure was identified in interviews with parents.Conclusions. Noncompliance with results of RDT tests is relatively rare when CHWs are trained and well supervised.Clinical Trials Registration. ISRCTN13858170.

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Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age

Cited by 35 publications

References 24 publications

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

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

A comparison of microscopic and rapid diagnostic test methods for diagnosis of malaria parasite.

Compliance With Malaria Rapid Diagnostic Testing by Community Health Workers in 3 Malaria-Endemic Countries of Sub-Saharan Africa: An Observational Study

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