Assessing the reliability of microscopy and rapid diagnostic tests in malaria diagnosis in areas with varying parasite density among older children and adult patients in Nigeria

Abstract

Background:Current malaria control strategies are based on early diagnosis and appropriate treatment of malaria cases. The study aimed at comparing the performance of blood film microscopy and rapid diagnostic test (RDT) in Plasmodium falciparum detection in patients ≥6 years of age.Materials and Methods:A total of 154 consecutive pyretic patients aged 6-62 years were enrolled, sampled, and tested for malaria using RDT (first response) and microscopy by Giemsa staining. Genomic DNA was extracted after saponin hemolysis and nested polymerase chain reaction (PCR) was used to detect Plasmodium falciparum. The endpoints were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results:Of the 154 patients, 80 (51.9%) had fever of ≥37.5°C. 106 (68.8%) were positive by First response®, 132 (85.7%) by microscopy, and 121 (78.6%) by PCR. The sensitivity, specificity, PPV, and NPV of first response compared to microscopic method were 82.2%, 100.0%, 100.0%, and 34.3%, respectively, while it was 75.4%, 75.0%, 95.3%, and 31.2%, respectively, when compared to PCR. The sensitivity, specificity, PPV, and NPV of the microscopic method compared to PCR were 92.3%, 50.0%, 90.91%, and 54.5%, respectively. There was a significant difference in the performance of RDT and film microscopy methods (P ≤ 0.05).Conclusion:Microscopy performed better and is more reliable than first response (RDT) in areas with low parasite density among patients ≥6 years of age. Rapid diagnostic tests could be useful in aareas with high parasite density as an alternative to smear microscopy

Epidemiology of falciparum malaria among residents of some rural and peri- urban communities in Ekiti State, Southwestern Nigeria

“…In the same vein, World Health Organization has observed that most prevalent malaria parasite species in sub Saharan Africa was P. falciparum (WHO, 2003). Indeed, the high malaria parasite prevalence recorded in this study was also similar to the reports of previous studies in other parts of Nigeria (Greenwood et al, 2005;Asaolu & Igbaakin, 2009;Okonko et al, 2009;Iwueze et al, 2014;Ayogu et al, 2016;Umma et al, 2017;Awosolu et al, 2019Awosolu et al, , 2020. However, malaria parasite prevalence in this study is greater than studies reported by Nzeako et al (2013), Udoh et al (2013) and Simon-Oke et al (2019).…”

Evaluating Malaria Prevalence Using Clinical Diagnosis Compared with Microscopy and Rapid Diagnostic Tests in a Tertiary Healthcare Facility in Rivers State, Nigeria

“…The overall malaria prevalence in this study using Giemsa microscopy as the gold standard was 43.1%. The study prevalence is comparable to 46.6% reported in Zamfara State [ 15 ], 40.8% in Rivers State [ 16 ], and 40.5% in South-Eastern Nigeria [ 17 ] but lower than 72.5% in Rivers State [ 18 ], 85.7% in Enugu State [ 19 ], and 71.4% in Cross River State [ 20 ]. The study prevalence (43.1%) is higher than 15.0% in Ogun State [ 21 ] and 14.7% in Lagos [ 22 ].…”

Performance of Microscopy Method and Rapid Diagnostic Tests in Malaria Diagnosis amongst Pregnant Women in Lagos, Southwest Nigeria

“…The performance of RDTs (aldolase) in malaria diagnosis in this study is in agreement with previous studies conducted, showing that RDTs performed better than microscopy in malaria diagnosis under field conditions [21,[30][31][32][33]. The performance of pLDH was well below optimum in sensitivity.…”