Low sensitivity but high specificity of ParaHIT-f in diagnosing malaria among children attending outpatient department in Butimba District Hospital, Mwanza, Tanzania

Abstract

Abstract:Malaria is the leading cause of mortality among under-fives in the sub-Saharan Africa. The gold standard method for the diagnosis of malaria is by the use of microscopy which is time consuming and requires skilled technicians. Recently the cost effective antigen based rapid diagnostic tests (RDTs) such as ParaHITf have been introduced in various places for the diagnosis of malaria. The choice of these RDTs to use in a certain country and specific geographical locations is critical to malaria diagnosis, treatment and ultimately control of drug resistance. This study was conducted to evaluate the sensitivity and specificity of the cheapest and easily available RDT in the study area, using microscopy as gold standard. This cross-sectional study was conducted to determine the performance of ParaHIT-f in diagnosing malaria in 300 children attending outpatient department at Butimba district hospital, Tanzania. Two thick and one thin blood smear were stained using standard Giemsa stain. The prevalence of Plasmodum falcparum malaria was 5.7% and 15.7% by ParaHIT-f and microscopy, respectively; the difference was significant (P<0.001). The sensitivity and specificity of ParaHIT-f were 29.8% and 98.8% respectively. There was a strong association between parasitaemia of ≥1000parasites/µl and being positive for ParaHIT-f diagnostic test (P <0.001). There is a need to revisit the use of ParaHIT-f in Tanzania. Further studies on the sensitivity and specificity are needed. A good quality control system on the performance of ParaHIT-f and other RDTs is highly recommended. ________________________________________________________________________________

Low sensitivity of ParaHIT-f rapid malaria test among patients with fever in rural health centers, Northern Tanzania

“…A similarly low sensitivity of the same test (9.6%) has been recorded in the Philippines, and a sensitivity of 29.8% to P. falciparum was reported from a holoendemic area of Tanzania in previous studies [10,17]. The observed results were inconsistent with those from similar studies in India and Tanzania, which have reported high sensitivity of the test raging from 70% -97% in different epidemiological settings [9,10,18,19].…”

“…For example, several studies from India and Tanzania have shown a high sensitivity and specificity of the ParaHIT-f rapid diagnostic test for diagnosis of Plasmodium falciparum malaria [9,12]. However, we have previously shown that, in a rural Tanzanian setting, sensitivity was low [10]. Thus monitoring the performance of ParaHIT-f, which is the most commonly used and inexpensive test available for malaria diagnosis in Tanzanian markets, remains important for accurate diagnosis and timely treatment of the disease.…”

“…One of these is ParaHIT-f which is currently marketed and used for malaria diagnosis in various regions in Tanzania and other African countries [9]. The test has been evaluated in various epidemiological settings in malarial endemic areas and the results on its sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) vary significantly [10,11]. For example, several studies from India and Tanzania have shown a high sensitivity and specificity of the ParaHIT-f rapid diagnostic test for diagnosis of Plasmodium falciparum malaria [9,12].…”

Sensitivity and Specificity of Clear View Malaria Dual Rapid Test® among Children Attending Hospital in Sengerema District, North-Western Tanzania

“…In the holoendemic areas of north-western Tanzania, the sensitivity and specificity of ParaHIT-f was 29.8%. There was a strong association between parasitaemia of ≥ 1000 parasites/μL and being positive for ParaHIT-f diagnostic test [16]. When the same test was subjected to an area characterized by low malaria transmission, the sensitivity was 10.7% [15].…”

“…In Tanzania, ParaHIT-f, ParaCheck-Pf and SD Bioline are currently been used for malaria diagnosis (National Malaria Control Programme personal Communication). In fact, SD Bioline has been recommended by the National Malaria Control Programme for use in all public health facilities [11][12][13][14][15]. The use of malaria RDTs have resulted into the decrease of misdiagnosis and use of ACTs among febrile patients in malaria endemic areas [7,12].…”