Comparative Assessment of Microscopy and Rapid Diagnostic Test (RDT) as Malaria Diagnostic Tools

Abstract

Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The aim of this study was to compare the effectiveness of RDT and microscopy in detection of malaria parasite in a malaria endemic area of Nigeria among different population groups. The cross sectional study was conducted on 251 febrile patients who were directed to the laboratory department for blood screening for malaria parasites at Ogunlade Hospital, Ijebu Ode, Ogun state. Blood samples were collected and screened for malaria parasites microscopically and by using First Response RDT. The prevalence of malaria obtained through microscopy (66.8%) was significantly higher than in RDT (36.8%) (p<0.05). Considering microscopy as the gold standard, RDT exhibited high specificity (87.1%) and low sensitivity (42.5%) with positive predictive and negative predictive values of 86.6 and 43.5%, respectively. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia (p<0.0001). The routine microscopy test demonstrated a superior sensitivity compared to First Response RDT method of malaria diagnosis, however, RDT could be a useful tool in individuals suspected to show high degree of disease spectrum for quick intervention in order to avert danger associated with delayed diagnosis.