Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection

Onyeka Linda Anagu,Ogwaluonye Uchenna C,Chinelo Kene Unachukwu,Moses Nkechukwu Ikegbunam,Charles Okey Esimone

doi:10.4236/aim.2015.58063

Abstract

Malaria infection is the most common diagnosis made in Africa. Efficient diagnosis of malaria parasite is very vital for treatment of malaria infection. The efficacy of rapid diagnostic tests (RDTs) in comparison to microscopy, the gold standard, in the diagnosis of malaria in Nigeria has not been fully ascertained. This study compared the sensitivity, specificity and predictive values of RDTs available in Nigeria market with microscopy. Two RDT kits were used and their results were compared with the gold standard, microscopy using thick and thin blood films (TBF and tBF). TBF had sensitivity of 85%, specificity of 30%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 66.6%; tBF had sensitivity of 80%, specificity of 35%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 63.6%. Among the RDTs, Care Start HRP2 kit had sensitivity of 65%, specificity of 50%, positive predictive value (PPV) of 56.5%, and negative predictive value (NPV) of 59% while SD Bioline kit had sensitivity of 55%, specificity of 65%, PPV of 61%, and NPV of 59%. It can thus be inferred that rapid diagnostic test kits are not as sensitive as microscopy in diagnosis of malaria parasite, but they are more accurate and are thus suitable alternatives to microscopy.

Highlights

Over-prescription and under-prescription of antimalarials are basically attributed to false-positive or false-nega-How to cite this paper: Anagu, O.L., Ikegbunam, M.N., Unachukwu, C.K., Uchenna C, O. and Esimone, C.O. (2015) Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection
Prevalence of Malaria Infections as Measured by the Microscopy and RDT The diagnostic value of Microscopy and RDTs in the detection of malaria parasites in South-east Nigeria was compared among symptomatic patients
For the thin blood film, the average percentage parasitemia was used to verify the presence of malaria parasite.17 (85%) patients were positive for malaria by thick blood film (TBF) and 16 (80%) by tBF

Summary

Introduction

Over-prescription and under-prescription of antimalarials are basically attributed to false-positive or false-nega-How to cite this paper: Anagu, O.L., Ikegbunam, M.N., Unachukwu, C.K., Uchenna C, O. and Esimone, C.O. (2015) Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection. Malaria is often diagnosed solely on the basis of clinical symptoms, irrespective of the outcome of laboratory testing, because most government and teaching hospitals still rely on the time-consuming microscopy in the laboratory diagnosis of malaria. Released merozoites can only invade a red blood cell, beginning the erythrocytic stage. The erythrocytic stage of malaria parasites has several important implications in clinical practice. This is the only stage causing the complex and varying spectrum of symptoms (fever, nausea, chills, vomiting, headache, fatigue and muscular aches) characterizing the disease in humans. The recognition of parasites in the blood of a patient allows the laboratory diagnosis of the infection and the differentiation of the various species as the causal agent [2]

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