Abstract
The study on the performance of four rapid diagnostic test (RDT) kits (Global, LabAcon, SD Bioline and CareStart kits) in the diagnosis of <i>Plasmodium falciparum</i> was carried in North Central Nigeria for a period of twelve months to evaluate the performance of the kits using samples of symptomatic patients attending clinic. The performance of the kits was compared with that of microscopy as standard. Result of the sensitivity of the four RDT kits revealed that Global, LabAcon, SD Bioline and CareStart recorded 86.50%, 84.90%, 86.50% and 83.70% respectively while their level of specificity was 95.40%, 95.30%, 95.80% and 96.00% respectively. The four kits recorded no significant difference in sensitivity and specificity (p>0.005). SD Bioline, however, demonstrated the highest accuracy of 92.90% while LabAcon had the lowest accuracy (92.10%). The positive predictive values and negative predictive values of the four kits were; Global (87.80% and 94.10%), SD Bioline (87.80% and 94.30%), LabAcon (86.20% and 94.10%) and CareStart (85.00% and 94.60%). There was no significant difference in either the accuracy, positive predictive value and negative predictive value of the four kits (p >0.005). The overall performance of the four kits was also insignificantly different (p>0.005). The performance of the four kits was statistically different compared with microscopy test (p<0.005), so the RDT kits cannot replace microscopy, being the gold standard but can, however, be used for malaria diagnoses for ease of analysis.
Highlights
Malaria presents a diagnostic challenge in most resource poor areas where malaria is epidemic
The finding from this study showed that SD Bioline and Global had positive predictive value (PPV) of 87.8% while LabAcon and CareStart had PPV of 86.2% and 85% respectively
The study compared the accuracy of four Rapid Diagnostic Tests (RDTs) (Care start, SD-Bioline, LabAcon and Global) with the traditional method of microscopy
Summary
Malaria presents a diagnostic challenge in most resource poor areas where malaria is epidemic. Malaria microscopy requires considerable skill, intensive labor and time leading to longer turn-around-time. Irrespective of these shortcomings, it is still the gold standard for diagnosis of malaria both in medical practice and research [1]. To maintain standard and quality, initial training and continuous retraining are needed both of which are challenging to maintain in poor countries where malaria is endemic. Lack of training and retraining on malaria microscopy has led to over diagnosis of malaria using this method [2]. Malaria Rapid Diagnostic Test kits were, developed and is being used in many countries to reduce the deficiencies of microscopy [3]
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