Comparative Use of RDT and Thick Film Microscopy in the Diagnosis of Malaria in Sub-urban Settlements in Makurdi, Nigeria

Abstract

In as much as accurate diagnosis seems to be the only way of effecting rational therapy, it has been the most neglected area of malaria research. Thick blood film microscopy and Rapid diagnostic test (RDT) was comparatively used to study malaria prevalence in Makurdi, Nigeria. A total of 328 blood samples were collected from consented respondents and analyzed using Blood film examination with Field’s stains A and B staining techniques and Care Start TM rapid diagnostic test (RDT) manufactured by Access Bio Inc, USA to detect the presence of malaria parasites in blood. Questionnaires were used to get demographics of the respondents. Of the 328 participants examined, 164(50.0%) were positive for malaria parasites by light microscopy and 32(9.8%) were positive for malaria by RDT Care Start TM HRP2. The sensitivity and specificity of RDT was found to be 16.5% and 97.0% respectively while the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) was found to be 84.4% and 53.7% respectively. The females 92(51.7%) and 20(11.2%) were slightly more infected than the males 72(48.0%) and 12(8.0%) using both methods, but result was not statistically significant (P>0.05). Malaria prevalence was higher among those with no formal education and least among those with tertiary education (P>0.05). The prevalence of malaria in respect to location was significantly higher in New GRA by RDT and Chile by light microscopy and least in High level and Agwan Jukum in order of RDT and microscopy (P=0.000). This study revealed that malaria can affect all sexes irrespective of their educational cadre and location. The Care Start TM RDT showed very poor sensitivity in contrast to light microscopy. In as much as light microscopy in poor set ups cannot be used routinely, the RDT has not proven to be a good replacement.