A diagnostic performance evaluation of rapid diagnostic tests and microscopy for malaria diagnosis using nested polymerase chain reaction as reference standard in a tertiary hospital in Jos, Nigeria

Autor: Daniel Z. Egah, Akaninyene A Otu, Okokon Ita Ita, Kenneth I. Onyedibe, Anthony A. Iwuafor, Edmund B. Banwat
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Fever
Cross-sectional study
Plasmodium falciparum
030231 tropical medicine
Nigeria
Polymerase Chain Reaction
Sensitivity and Specificity
Tertiary Care Centers
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
parasitic diseases
Prevalence
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Malaria
Falciparum
Child
Prospective cohort study
Reference standards
Aged
Microscopy
Rapid diagnostic test
biology
business.industry
Infant
Newborn
Public Health
Environmental and Occupational Health
Infant
Diagnostic test
General Medicine
Middle Aged
Reference Standards
biology.organism_classification
medicine.disease
Cross-Sectional Studies
Infectious Diseases
Child
Preschool
Female
Parasitology
business
Nested polymerase chain reaction
Malaria
Zdroj: Transactions of The Royal Society of Tropical Medicine and Hygiene. 112:436-442
ISSN: 1878-3503
0035-9203
DOI: 10.1093/trstmh/try071
Popis: Background Rapid diagnostic tests are frequently used in healthcare settings across Nigeria for diagnosis of Plasmodium falciparum malaria, which is the commonest form of malaria in the country. In this study, the performance of a rapid diagnostic test (RDT) was compared with expert microscopy using the polymerase chain reaction (PCR) as the reference standard in a tertiary hospital in Jos, Nigeria. Methods This study was a prospective, cross-sectional, hospital-based study. A total of 200 participants of all ages presenting to Jos University Teaching Hospital with a history of fever or an axillary temperature of >37.5°C were recruited. Blood specimens were collected and malaria testing was done using RDT, microscopy and PCR. Results The prevalence of malaria in this study was 17%, 15% and 13% by PCR, microscopy and RDT, respectively. Compared with microscopy, RDT had lower sensitivity of 75% (95% CI: 56.60-88.54) vs 88.24% (95% CI: 72.55-96.70), lower specificity of 98.80% (95% CI: 95.72-99.85) vs 100.0% (95% CI: 97.80-100.0), lower positive predictive value 92.31 (95% CI: 74.89-97.97) vs 100 (95% CI: 98.0-100.0), and lower negative predictive value 95.35 (95% CI: 91.83-97.39) versus 97.65 (95% CI: 94.30-99.05). Conclusion The diagnostic performance of expert microscopy was better than RDT in the diagnosis of Plasmodium falciparum malaria. Quality assurance procedures such as using expert microscopy to cross-check a proportion of RDT negative results in patients with clinical features of malaria is desirable.
Databáze: OpenAIRE
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