Performance of Four Malaria Rapid Diagnostic Tests (RDTs) in the Diagnosis of Malaria in North Central Nigeria

Abstract

The study on the performance of four rapid diagnostic test (RDT) kits (Global, LabAcon, SD Bioline and CareStart kits) in the diagnosis of Plasmodium falciparum was carried in North Central Nigeria for a period of twelve months to evaluate the performance of the kits using samples of symptomatic patients attending clinic. The performance of the kits was compared with that of microscopy as standard. Result of the sensitivity of the four RDT kits revealed that Global, LabAcon, SD Bioline and CareStart recorded 86.50%, 84.90%, 86.50% and 83.70% respectively while their level of specificity was 95.40%, 95.30%, 95.80% and 96.00% respectively. The four kits recorded no significant difference in sensitivity and specificity (p>0.005). SD Bioline, however, demonstrated the highest accuracy of 92.90% while LabAcon had the lowest accuracy (92.10%). The positive predictive values and negative predictive values of the four kits were; Global (87.80% and 94.10%), SD Bioline (87.80% and 94.30%), LabAcon (86.20% and 94.10%) and CareStart (85.00% and 94.60%). There was no significant difference in either the accuracy, positive predictive value and negative predictive value of the four kits (p >0.005). The overall performance of the four kits was also insignificantly different (p>0.005). The performance of the four kits was statistically different compared with microscopy test (p<0.005), so the RDT kits cannot replace microscopy, being the gold standard but can, however, be used for malaria diagnoses for ease of analysis.