Comparative Performance of Four Rapid Diagnostic Tests Kits, Microscopy and PCR in Asymptomat-ic Malaria Detection among Children from Ilishan-Remo Community, Southwest Nigeria
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Active malaria parasite detection is essential for effective malaria control and elimination in endemic settings. Asymptomatic malaria is often not detected and serves as a parasite reservoir for continuous malaria transmission. This study evaluated the comparative performance of four RDT kit brands, microscopy, and PCR to detect asymptomatic infection among children from the Ilishan-Remo community in Ogun state, southwest Nigeria. Methods: A cross-sectional study design was carried out to actively detect asymptomatic parasitaemia in children aged 3 months to 10 years during the dry season (November and December, 2022). Finger prick blood samples were collected for rapid diagnostic tests using SD-BiolineTM, Micro-pointTM, CarestartTM, and First-ResponseTM. Thick blood smears were prepared for microscopy, and dried blood spots for PCR analysis. The performance of the diagnostic methods was compared. Results: Of the 163 samples analysed, parasite positive rate as detected by PCR was 34 (20.9%), microscopy 38 (23.3%), SD-BiolineTM 19 (11.7%), Micro-pointTM 20 (12.3%), CareStartTM 25 (15.3%), and First-ResponseTM 23 (14.1%) respectively. The Sensitivity was 45.5%, 50.0%, 56.2%, 51.5%, and 70.0% for SD-BiolineTM, Micro-pointTM, CareStartTM, First-ResponseTM, and microscopy (p = 0.000), while specificity was 96.9%, 97.7%, 94.4%, 95.2% and 91.9% (p = 0.116) respectively. There was a significant statistical difference in the PPV (p = 0.037), while the NPV, accuracy, and kappa (k) were statistically not significant. Conclusion: Microscopy has shown a higher sensitivity and positive predictive value than rapid RDTs in detecting asympto-matic parasitaemia compared with PCR. This underscores the need for developing ultra-sensitive, cost-effective, and point-of-care diagnostic tools. Such tools could significantly enhance the control and elimination of malaria by actively detecting asymptomatic infection and reducing the parasite reservoir and malaria burden in Nigeria.
Authors: Chika C. Okangba, Roland I. Funwei, Wasiu A. Hammed, Oluwole T. Oluwaseun, Hillary N. Okunbor, Vic-tor U. Nwadike, Tayo Babatunde, Abolanle A. Akeredolu, Ebunoluwa T. Opabola, Gift U. Okangba, Olanrewaju A. Solanke, Otaigbe I. Imonihe, Aigbede Osatohanmwen, Christine O. Akinsanya, Nnaemeka. G. Egejuru, Zadok E. Evwierhoma, Debora E. Ohemu, Elizabeth O. Oyeyemi, Oluwademilade Oyewolu, Ellen O. Ikechukwu, Olu-watosin F. Adeyemo, Chidebere A. Omeonu, Alexandria A. Okorie, Chidebere. G. Okangba, Charles J. Elikwu
Institutions: Babcock University, University of Lagos
Language: English
Topic: Malaria Research and Control
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402697089