AiM  Vol.5 No.8 , August 2015
Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection
Abstract: Malaria infection is the most common diagnosis made in Africa. Efficient diagnosis of malaria parasite is very vital for treatment of malaria infection. The efficacy of rapid diagnostic tests (RDTs) in comparison to microscopy, the gold standard, in the diagnosis of malaria in Nigeria has not been fully ascertained. This study compared the sensitivity, specificity and predictive values of RDTs available in Nigeria market with microscopy. Two RDT kits were used and their results were compared with the gold standard, microscopy using thick and thin blood films (TBF and tBF). TBF had sensitivity of 85%, specificity of 30%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 66.6%; tBF had sensitivity of 80%, specificity of 35%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 63.6%. Among the RDTs, Care Start HRP2 kit had sensitivity of 65%, specificity of 50%, positive predictive value (PPV) of 56.5%, and negative predictive value (NPV) of 59% while SD Bioline kit had sensitivity of 55%, specificity of 65%, PPV of 61%, and NPV of 59%. It can thus be inferred that rapid diagnostic test kits are not as sensitive as microscopy in diagnosis of malaria parasite, but they are more accurate and are thus suitable alternatives to microscopy.
Cite this paper: Anagu, O. , Ikegbunam, M. , Unachukwu, C. , Uchenna C, O. and Esimone, C. (2015) Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection. Advances in Microbiology, 5, 604-609. doi: 10.4236/aim.2015.58063.

[1]   Ameh, J., Ahmad, R.M., Ekeh, N., Linga, P., Mangoro, Z., et al. (2012) Laboratory Diagnosis of Malaria: Comparing Giemsa Stained Thick Blood Films with Rapid Diagnostic Test (RDT) in an Endemic Setting in North-West Nigeria. Journal of Medical Laboratory and Diagnosis, 3, 10-15.

[2]   Graham, P.C.C. (1996) Malaria Parasites and Other Haemosporida. Blackwell Scientific Publication, Oxford.

[3]   Silviee, O., Mata, M.M., Matuschewski, K. and Prudencio, M. (2008) Interactions of the Parasite and Its Mammalian Host. Current Opinion in Microbiology, 11, 352-359.

[4]   Cowman, A.F. and Crabb, B. (2006) Invasion of Red Blood Cells by Malaria Parasite. Cell, 124, 755-766.

[5]   Murray, C.K., Bell, D., Grasser, R.A. and Wongsrichanalai, C. (2003) Rapid Diagnostic Testing for Malaria. Tropical Medicine & International Health, 8, 876-883.

[6]   Piper, R, Vanderjagt, L., Holbrook, J.J. and Makler, M. (1996) Malaria Lactate Dehydrogenase; Target for Diagnosis and Drug Development. Annals of Tropical Medicine & Parasitology, 90, 433.

[7]   Chessebrough, M. (2009) District Laboratory Practice in Tropical Countries.

[8]   Sun, X.D., Tambo, E., Wei, C., Chen, Z.B., Deng, Y., Wang, J., Wang, J.Z. and Zhou, X.N. (2013) Diagnostic Performance of CareStartTM Malaria HRP2/pLDH (Pf/pan) Combo Test versus Standard Microscopy on Falciparum and Vivax Malaria between China-Myanmar Endemic Borders. Malaria Journal, 12, 6.

[9]   Sheyin, Z. and Bigwan, I.E. (2013) Comparison of CARE START HRP2 Rapid Malaria Test with Light Microscopy for Guiding Patient’s Treatment of Fever in Nigeria Endemic Areas. Journal of Medicine and Medical Sciences, 4, 353-356.

[10]   Cheng, Q., Cloonan, N., Fischer, K., et al. (1998) Stevor and Rif Are Plasmodium falciparum Multicopy Gene Families Which Potentially Encode Variant Antigens. Molecular and Biochemical Parasitology, 97, 161-176.

[11]   WHO (2003) Malaria Rapid Diagnosis: Making It Work. World Health Organization, Manila.

[12]   Ojurongbe, O., Adegbosin, O.O., Taiwo, S.S., Oyebode, A.T., Olowe, O.A., Ojurongbe, T.A., et al. (2013) Assessment of Clinical Diagnosis, Microscopy, Rapid Diagnostic Tests, and Polymerase Chain Reaction in the Diagnosis of Plasmodium falciparum in Nigeria. Malaria Diagnosis and Treatment, 2013, Article ID: 308069.

[13]   Moody, A., Hunt-Cooke, A., Gabbett, E. and Chiodini, P. (2000) Performance of the OptiMAL Malaria Antigen Capture Dipstick for Malaria Diagnosis and Treatment Monitoring at the Hospital for Tropical Diseases, London. British Journal of Haematology, 109, 891-894.

[14]   Miller, R.S., McDaniel, P. and Wongsrichanalai, C. (2001) Following the Course of Malaria Treatment by Detecting Parasite Lactate Dehydrogenase Enzyme. British Journal of Haematology, 113, 558-559.

[15]   Humar, A., Ohrt, C., Harrignton, M.A., Pillai, D. and Kain, K.C. (1997) Parasight F Test Compared with the Polymerase Chain Reaction and Microscopy for the Diagnosis of Plasmodium falciparum Malaria in Travelers.

[16]   Mishra, B., Samantaray, J.C., Kumar, A. and Mirdha, B.R. (1999) Study of False Positivity of Two Rapid Antigen Detection Tests for Diagnosis of Plasmodium falciparum Malaria. Journal of Clinical Microbiology, 37, 1233.

[17]   Laferl, H., Kandel, K. and Pichler, H. (1997) False Positive Dipstick Test for Malaria. New England Journal of Medicine, 337, 1635-1636.

[18]   Biswas, S., Tomar, D. and Rao, D.N. (2005) Investigation of the Kinetics of Histidine-Rich Protein 2 and of the Antibody Responses to This Antigen, in a Group of Malaria Patients from India. Annals of Tropical Medicine & Parasitology, 99, 553-562.