The diagnostic performance of rapid diagnostic tests and microscopy for malaria diagnosis in eastern Sudan using a nested polymerase chain reaction assay as a reference standard

Abstract

Background Accurate diagnosis of malaria infection is essential for successful control and management of the disease. Both microscopy and rapid diagnostic tests (RDTs) are recommended for malaria diagnosis, however, RDTs are more commonly used. The aim of the current study was to assess the performance of microscopy and RDTs in the diagnosis of Plasmodium falciparum infection using a nested polymerase chain reaction (PCR) assay as the gold standard. Methods A cross-sectional study was carried out in Kassala Hospital, eastern Sudan. A total of 341 febrile participants of all ages were recruited. Blood specimens were collected and malaria testing was performed using an RDT (SD Bioline Malaria Ag Pf), microscopy and nested PCR. The sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) of microscopy and the RDT were investigated. Results The prevalence of P. falciparum malaria infections in this study was 22.9%, 24.3% and 26.7% by PCR, microscopy and RDT, respectively. Compared with microscopy, the RDT had slightly higher sensitivity (80.7% vs 74.3%; p=0.442), equivalent specificity (89.3% vs 90.4%), a similar PPV (69.2% vs 69.8%) and a higher NPV (94.0% vs 92.2%). Conclusions The diagnostic performance of the RDT was better than that of microscopy in the diagnosis of P. falciparum malaria when nested PCR was used as the gold standard.

Anemia among Schoolchildren with Malaria and Soil-Transmitted Helminth Coinfections after Repeated Rounds of Mass Drug Administration in Muheza District, Tanzania

“…However, recent studies have shown mRDT to be more reliable than microscopy. 41,42 In addition, collection of single slides for STHs might have biased the findings considering day-to-day variability of STH eggs excretion as well as in children with low intensity. Inclusion of schoolchildren present on the day of the survey may introduce minimal selection bias; however, our study team did community sensitization through school, ward, and village meetings with leaders who communicated with the parents.…”

Summary of discordant results between rapid diagnosis tests, microscopy, and polymerase chain reaction for detecting Plasmodium mixed infection: a systematic review and meta-analysis

“…RDTs targeting HRP2 are specific for the detection of P. falciparum , while RDTs targeting LDH can be used for the detection of P. falciparum , P. vivax , or pan-specific (e.g., four Plasmodium species) LDH antibodies; aldolase is another common target for RDTs to detect all Plasmodium species 7 – 10 . Recently used commercial dipsticks for the detection of HRP-2 include PfHRP2 CareStart 11 – 13 , SD Bioline Malaria Ag Pf 14 , 15 , and SD BIOLINE Malaria Ag P.f/Pan 16 , and one recently used for the detection of pLDH is CareStart pLDH(pan) 15 . A recently used commercial dipstick for the detection of Pan-aldolase is ParaHit Total, while a recently used commercial dipsticks for the detection of P. vivax aldolase is mAb 1C3-12 F10 17 .…”

A Deep Learning Approach for Segmentation of Red Blood Cell Images and Malaria Detection

“…Accuracy was not a good indicator due to the limitation that implies the imbalance of the test set (1 parasitized erythrocyte per every 4 healthy RBCs). Comparing the performance of the CNN to the gold standard, the microscopic analysis of stained blood films: NPV (84%) and specificity (87%) are similar to the gold standard (90.40% and 92.20%, respectively), but PPV (23%) and sensitivity are not (18%), as in the gold standard they are 69.80% and 74.30% [ 24 ]. It should be taken into account that the training and validation sets had the same origin (Malaria dataset from the LHNCBC) and the test set did not as it was part of the collection of images of the research group [ 14 , 25 ] and too small to be used also for training and validation.…”