Evaluation of microscopy and rapid diagnostic tests for diagnosing malaria among febrile subjects in Ezinihitte local government area, Imo state Nigeria

Abstract

Malaria is the leading cause of morbidity and mortality in Nigeria, the country accounting for the highest devastation worldwide. This study aimed at evaluating the performance of microscopy and rapid diagnostic tests (RDTs) for diagnosis of malaria. A total of 443 suspected Plasmodium falciparum infected patients in hospitals in selected communities of Ezinihitte Local Government Area south eastern Nigeria between January and June 2014 were examined by using microscopy and RDTs. Thick and thin blood smears made on clean slides from venipuncture blood collected from febrile subjects have been examined for the presence of malarial parasites. Serological diagnosis was performed using Carestart, SD Bioline and Antec kits. The overall prevalence of the three RDTs were Carestart pf (41.8%), SD Bioline pf (52.8%), and Antec pf/pv (25.3%) as against microscopy the standard (44.9%). The varied prevalence observed from the three kits did not differ statistically (p>0.05).The females appeared to have more infected (42.4%) than the males (39.6%) with no significant difference between the diagnostic methods. The overall sensitivities of Carestart pf, SD Bioline pf and Antec pf/pv were 71.9%, 86.9% and 50.8% respectively while their corresponding specificities were 82.8%, 75.0%, and 95.5% respectively. SD Bioline HRP2 based test demonstrated a superior sensitivity compared to microscopy. Some RDTS can be useful alternatives to microscopy in the diagnosis of P. falciparum especially in resource limited communities.