Point-of-Care Evaluation of Malaria Rapid Diagnostic Test (mRDT) for Detection of Plasmodium falciparum Among Children Under 5 Years of Age Attending Panyadoli Health Center III in Kiryandongo Refugee Settlement, Mid-Western Uganda.

Background: Malaria places a significant burden on Africa, accounting for 95% of global cases and 96% of malaria-related deaths, with children under five comprising 80% of these fatalities. Refugees and displaced persons face higher risks due to overcrowding and limited healthcare. The aim of this study was to compare the diagnostic performance of Malaria Rapid Diagnostic Test (mRDT) with microscopy among children under 5 years old who sought medical care at Panyadoli Health Center III in Panyadoli Refugee Settlement, Kiryandongo District, Uganda. Methods: A cross-sectional study was conducted among refugee children under 5 years old from February to April 2023. A total of 380 blood specimens were obtained using the finger prick method and examined for malaria parasites using mRDT and microscopy. A structured questionnaire was used to collect sociodemographic characteristics of the respondents. Data were analyzed using descriptive statistics, while Kappa value was used to provide insights into the agreement between the two diagnostic methods. Results: The prevalence of malaria among the study participants using mRDT and microscopy was 12.8% (95% CI: 8.0%-17.8%) and 12.2% (95% CI: 7.4%-17.4%), respectively. The sensitivity (Sn) and specificity (Sp) of mRDT were 94.5% (95% CI: 89%-98%), Sp at 94.0% (95% CI: 87%-98%), positive predictive value (PPV) at 92.0% (95% CI: 85%-96%), and negative predictive value (NPV) at 97.0% (95% CI: 93%-100%). The Sn and Sp of microscopy were 92.5% (95% CI: 87%-98%), Sp was 96.8% (95% CI: 91%-99%), PPV was 94.5% (95% CI: 89%-98%), and NPV was 97.5% (95% CI: 93%-99%). The overall kappa statistic (κ) for agreement between mRDT and microscopy was 0.75 (95% CI: 0.70-0.80), reflecting moderate to strong agreement between the two diagnostic methods. Conclusion: The study found comparable malaria prevalence using mRDT and microscopy. Both methods showed high Sn and Sp with moderate to strong agreement, supporting mRDT's reliability in diagnosis. Due to its high accuracy and strong agreement with microscopy, mRDT can reliably diagnose malaria in resource-limited settings; however, confirmatory testing and periodic quality controls are recommended for accuracy and case management.