Comparative evaluation of three histidine-rich Protein-2 based rapid diagnostic tests, microscopy and PCR for guiding malaria treatment in Ibadan, Southwest Nigeria.

Abstract

BACKGROUND:

Malaria rapid diagnostic tests (mRDTs) are the preferred option for programmatic deployment.

AIMS:

There are numerous mRDTs on the Nigerian market and there is a need to guide practitioners on the relative performance of the commonly used brands of mRDT in Nigeria.

SUBJECTS AND METHODS:

The performance of three commonly used Histidine-Rich-Protein-2-based mRDTs (SD-Bioline™, Carestart™ and Paracheck-Pf™) against microscopy of Giemsa stained blood and polymerase chain reaction (PCR) was evaluated among 190 febrile under-5 children in Ibadan, Nigeria. We calculated the sensitivity, specificity, predictive values, accuracy, and agreements.

RESULTS:

There were 53.2% males. The prevalence of malaria parasite by microscopy was 46.8% and 57.9% by PCR. Malaria parasite detection by SD-Bioline™ was 60.5%, Carestart™: 60.0% and Paracheck-Pf™ 60.0%. Using microscopy as the gold standard, the sensitivities of SD-Bioline™, Carestart™ and Paracheck-Pf™ mRDT were 97.8%, 96.7% and 97.8% respectively while the specificities were 73.0%, 72.0% and 74.0% respectively. Using PCR as the gold standard, the sensitivity for both SD-Bioline™ and Paracheck-Pf™ was 85.5% and for CareStart was 84.6% while the specificity of SD-Bioline™, Carestart™, and Paracheck-Pf™ was 73.8%, 72.4%, and 75.0% respectively. The test accuracy was 81.0% for both SD-Bioline™ and Paracheck-Pf™ and 80.0% for Caresatrt™. The kappa coefficient of agreement between PCR and each of SD-Bioline™, Carestart, ParaCheck™ and microscopy was 0.597, 0.578, 0.609 and 0.739 respectively.

CONCLUSION:

The performance of the three mRDTs is a proof that any of the three is suitable for use in the diagnosis of malaria in the southwest of Nigeria.

• Authors: A E Orimadegun, R I Funwei, O S Michael, O O Ogunkunle, J A Badejo, F I Olusola, O Agede, O E Anjorin, I O Ajayi, A S Jegede, O Ojurongbe, C O Falade
• Journal: Nigerian journal of clinical practice (Niger J Clin Pract) Vol. 24 Issue 4 Pg. 496-504 (Apr 2021) ISSN: 1119-3077 [Print] India
• PMID: 33851670 (Publication Type: Journal Article)

Chemical References

• Histidine

Topics

• Child
• Diagnostic Tests, Routine
• Female
• Histidine
• Humans
• Malaria (diagnosis)
• Malaria, Falciparum (diagnosis, epidemiology)
• Male
• Microscopy
• Nigeria
• Plasmodium falciparum
• Polymerase Chain Reaction
• Sensitivity and Specificity