Comparative Evaluation of Three Histidine‑Rich Protein‑2 Based Rapid Diagnostic Tests, Microscopy and PCR for Guiding Malaria Treatment in Ibadan, Southwest Nigeria
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Date
2021-04-14
Journal Title
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Publisher
National body of the Medical and Dental Consultants’ Association of Nigeria
Abstract
Background: Malaria rapid diagnostic tests (mRDTs) are the preferred
option for programmatic deployment. Aims: There are numerous mRDTs
on the Nigerian market and there is a need to guide practitioners on the
relative performance of the commonly used brands of mRDT in Nigeria.
Subjects and Methods: The performance of three commonly used
Histidine‑Rich‑Protein‑2‑based mRDTs (SD‑Bioline™, Carestart™ and
Paracheck‑Pf™) against microscopy of Giemsa stained blood and polymerase
chain reaction (PCR) was evaluated among 190 febrile under‑5 children in Ibadan,
Nigeria. We calculated the sensitivity, specificity, predictive values, accuracy, and
agreements. Results: There were 53.2% males. The prevalence of malaria parasite
by microscopy was 46.8% and 57.9% by PCR. Malaria parasite detection by
SD‑Bioline™ was 60.5%, Carestart™: 60.0% and Paracheck‑Pf™ 60.0%. Using
microscopy as the gold standard, the sensitivities of SD‑Bioline™, Carestart™
and Paracheck‑Pf™ mRDT were 97.8%, 96.7% and 97.8% respectively while the
specificities were 73.0%, 72.0% and 74.0% respectively. Using PCR as the gold
standard, the sensitivity for both SD‑Bioline™ and Paracheck‑Pf™ was 85.5% and
for CareStart was 84.6% while the specificity of SD‑Bioline™, Carestart™, and
Paracheck‑Pf™ was 73.8%, 72.4%, and 75.0% respectively. The test accuracy was
81.0% for both SD‑Bioline™ and Paracheck‑Pf™ and 80.0% for Caresatrt™. The
kappa coefficient of agreement between PCR and each of SD‑Bioline™, Carestart,
ParaCheck™ and microscopy was 0.597, 0.578, 0.609 and 0.739 respectively.
Conclusion: The performance of the three mRDTs is a proof that any of the three
is suitable for use in the diagnosis of malaria in the southwest of Nigeria.
Description
Keywords
HRP‑2 Malaria‑RDTs, microscopy, Nigeria, PCR