scholarly journals Diagnostic Performance between Histidine-Rich Protein 2 (HRP-2), a Rapid Malaria Diagnostic Test and Microscopic-Based Staining Techniques for Diagnosis of Malaria

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Jean Baptiste Niyibizi ◽  
Emmanuel Kamana Gatera
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Health Centre ◽  
Malaria Diagnosis ◽  
High Specificity ◽  
Cross Sectional Study ◽  
Diagnostic Challenge ◽  
Cross Sectional ◽  
Predictive Values ◽  
Study Participants

Malaria presents a diagnostic challenge in most tropical countries such as Rwanda. Microscopy remains the gold standard for diagnosing malaria, but it is labor intensive and depends upon the skill of the examiner. Malaria rapid diagnostic tests (RDTs) have been developed as an easy, convenient alternative to microscopy. This cross-sectional study was conducted at Rukara Health Center which is located in Eastern Province, Kayonza district, Rwanda. One hundred and fifty suspected cases of malaria, who attended Rukara Health Centre, during the period, from 21st June to 30th July 2018, were included in this study. HRP-2 RDTs (CareStart™ Malaria HRP-2 (Access Bio, Inc., Somerset, New Jersey, USA)), for malaria were performed. Thick smears were prepared and Giemsa-stained as recommended; then slides were observed under microscopy and reported quantitatively; RDTs were reported qualitatively (positive or negative). Both RDTs and thick smear results were recorded on data collection sheet. This study included a total of 150 study participants, 87 (58%) females and 63 (42%) males. The patients included in the study did not receive any antimalarial drug. The mean age of the study participants was 31.6 ± 12.4 with the majority of participants being between 25 and 44 years and the minority being above 65 years. The sensitivity of RDT (HRP-2) was calculated and found to be 95.0%, whereas the sensitivity of Giemsa microscopy was 100%. The specificity of RDT (HRP-2) was calculated and found to be 59.2%, whereas the specificity of Giemsa microscopy was 100%. Negative and positive predictive values of RDT are 85.4% and 82.7%, respectively. Negative and positive predictive values of Giemsa microscopy were both 100%. According to the results of the current study, the sensitivity, specificity, and both positive and negative predictive values of Giemsa microscopy are higher than those of histidine-rich protein 2-based rapid diagnostic test for malaria. The results obtained in histidine-rich protein 2-based rapid diagnostic test for malaria parasites should be confirmed with tests with high specificity. Further studies should determine the most appropriate type of rapid diagnostic test of malaria diagnosis to be used in combination with Giemsa microscopy. In addition, sensitivity and specificity of RDT (HRP-2) and Giemsa microscopy should be assessed against molecular biology techniques.

scholarly journals A comparative assessment of Rapid Diagnosis Test (RDT) versus microscopy for malaria diagnosis in health care facilities

2020 ◽  
Author(s):  
Theresia Njuabe Metoh ◽  
Chi Tchampo Fru ◽  
Philip FonGah ◽  
Xiaonong Zhou
Keyword(s):  
Delayed Diagnosis ◽  
Malaria Diagnosis ◽  
High Specificity ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Age Group ◽  
Cross Sectional ◽  
Predictive Values ◽  
Disease Spectrum

Abstract Background: Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The objective of this study was to determine the best approach on malaria diagnosis in detection of malaria parasite in the Northwest region, of Cameroon among different population groups. Materials and method: The cross sectional study was conducted on 60 febrile patients who were directed to the laboratory department for blood screening at the Bamenda Regional Hospital after showing signs and symptoms of malaria infection. Blood sample were collected aseptically and dispensed into an EDTA container where RDTs and microscopic examination were performed to assess the presence of malaria parasites. Results from the rapid diagnostic kits were analyzed and compared to those obtained by general microscopy. Results : Of the 60 samples enrolled 37 (61.7%) were found to be positive with blood films examination while in rapid diagnostic test 27 (45%) were positive. Based on frequency of infection by age 20-35 years had 13 (35.1%) as the most vulnerable group, followed by 0 -5 year with 11 (29.7%), 6-19 had 6 (16.2%) while age group of 36-59 had 5 (16.0%) and lastly the age group of 60 and above had least value of 2 (5.4%). The prevalence of malaria obtained through microscopy (62%) was significantly higher than in RDT (45%). Considering microscopy as the gold standard, RDT exhibited high specificity (100%) and sensitivity (73%) with positive predictive and negative predictive values of 100% and 70%, respectively. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia which was the plasmodium specie detected in all positive cases. Conclusion: The study, therefore, highlights that the routine microscopy test demonstrated a superior sensitivity compared to 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.

scholarly journals Evaluation of a Rapid Diagnostic Test Currently Being Used in the Management of Malaria in Patients of the Hia/Chu-Parakou and the Boko Zone Hospital in Northern Benin

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Tokponnon F ◽  
◽  
Osse R ◽  
Houessou C ◽  
Akogbeto M ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Probabilistic Method ◽  
Health Centers ◽  
Patient Identification ◽  
Cross Sectional ◽  
Predictive Values ◽  
Parasitological Diagnosis ◽  
Sensitivity Specificity ◽  
Adequate Management

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.

scholarly journals Comparative Study of Malaria Diagnosis: Rapid Diagnostic Test (RDTs) Against Microscopy among Pregnant Women Attending Antenatal Clinic in Specialist Hospital, Sokoto

2021 ◽  
pp. 9-16
Author(s):  
K. Mohammed ◽  
M. U. Iduh ◽  
S. M. Saheed ◽  
O. F. Ashcroft ◽  
M. K. Garba ◽  
...  
Keyword(s):  
Comparative Study ◽  
Pregnant Women ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Study Design ◽  
Gold Standard ◽  
Malaria Parasite ◽  
Malaria Diagnosis ◽  
Sub Saharan Africa ◽  
Cross Sectional

Background: Malaria is an infectious disease caused by a protozoan parasite of the genus Plasmodium. It was estimated that 219 million cases of malaria occur in 87 countries, with an estimated death of 435,000 in 2017 among pregnant women. Other species include P. ovale, P. vivax, and P. malariae is a blood parasite of human and is one of the major public health burdens in developing countries, particularly in Sub-Saharan Africa. It is estimated that about 3.5 billion people globally and 450 million people are thought to be ill as a result of such infections, the majority being children. Aims: This study was aimed at comparing RDTs against microscopy in the detection of malaria parasite among pregnant women. Samples were collected and analyzed following cross-sectional comparative study design. It was conducted between Septembers to November 2019. Study Design: This was a cross-sectional, comparative study Place and Duration of Study: This study was conducted among patients attending Specialist Hospital Sokoto, Sokoto State, between March and November, 2019. Methodology: A total of 106 participants were enrolled for the study. Standard parasitological examination was carried out on blood samples using microscopy followed by Rapid Diagnostic test (RDTs). Results: Finding revealed, in this study, CareStart kit had sensitivity of 77.7%, specificity of 100s%. It is expected that any RDT used for malaria diagnosis should have a high sensitivity of 95% and specificity 97% (WHO, 2003); this is in contrast with the RDTs results in this study. The false negative (FN) Carestart and SD-Bioline kits in this study were 10% and 21%, respectively using microscopy as the gold standard due to lack of sensitivity of RDTs at low parsitaemia compared to microscopy. The false positive rate in this study for the Carestart and SD-Bioline kits are 0% and 0% respectively. Out of 106 patients screened, 35% and 24% tested positive for Plasmodiumfalciparum using Carestart and SD-Bioline RDTs respectively, while 45% were positive to malaria by microscopic examination. There was high prevalence of malaria parasite among age group 18-23 which is 42.2%. Conclusion: It can be concluded that using microscopy is more time consuming compared to RDTs due to the fact that the time taken to read the results for RDTs is within five minutes and that of microscopy is higher compared to RDTs. Over all prevalence of malaria by microscopy was 42.5% while the prevalence of malaria by Carestart and SD-bioline was 33% and 22.6% respectively. Conventional microscopy remains the gold standard compared to RDTs according to this study with the level of its sensitivity and specificity which is higher than RDTs.

scholarly journals Performance of Laboratory Professionals Working on Malaria Microscopy in Tigray, North Ethiopia

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Megbaru Alemu ◽  
Desalegn Tadesse ◽  
Tesfaye Hailu ◽  
Wondemagegn Mulu ◽  
Awoke Derbie ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Microscopic Analysis ◽  
Malaria Diagnosis ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Kappa Score ◽  
Cross Sectional ◽  
Panel Testing ◽  
Study Participants ◽  
Malaria Microscopy

Background. Microscopic analysis of stained blood smear is the most suitable method of malaria diagnosis. However, gaps were observed among clinical laboratory professionals in microscopic diagnosis of malaria. Methods. A cross-sectional study was conducted in December 2015 among 46 laboratory professionals. Data was collected via on-site assessment and panel testing. The slide panel testing was composed of positive and negative slides. The kappa score was used to estimate the agreement between participants and reference reader. Results. The overall agreement between the study participants and the reference reader in malaria detection was 79% (kappa = 0.62). Participating in refresher training on malaria microscopy (Adjusted Odds Ratio (AOR = 7, CI = 1.5–36.3)) and malaria epidemic investigation (AOR = 4.1 CI = 1.1–14.5) had statistical significant association with detection rate of malaria parasites. Conclusion. Laboratory professionals showed low performance in malaria microscopy. Most of the study participants were graded “in-training” in laboratory diagnosis of malaria.

scholarly journals Mentorship on Malaria Microscopy Diagnostic Service in Ethiopia: Baseline Competency of Microscopists and Performance of Health Facilities

2020 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria case is declining as a result of proven interventions and the country launched malaria elimination strategy in targeted settings since 2017. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop continuation of the transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out toevaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 01 to September 30, 2019 in nine Regional States and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using WHO certified slides from national slide bank in public health institute. Strength of agreement, sensitivity, specificity and positive and negative predictive values were calculated.Results: In this study, 102 health facilities (84 health centers and 18 hospitals) were included; from which, 202 laboratory professionals participated. In slide re-checking, moderate agreement (Agreement: 76.0%; Kappa: 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the rechecking results were 78.1% and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Therefore, implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are the key strategies to improve the overall performance of health facilities in malaria microscopy.

scholarly journals Accuracy of SD Malaria Ag P.f/Pan® as a rapid diagnostic test in French Amazonia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jean Marc Pujo ◽  
Stéphanie Houcke ◽  
Sarah Lemmonier ◽  
Patrick Portecop ◽  
Alexis Frémery ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Rapid Test ◽  
Malaria Diagnosis ◽  
Blood Film ◽  
Test Results ◽  
Predictive Values ◽  
Imported Cases ◽  
Remote Healthcare

Abstract Background French Guiana (FG) is a French overseas territory where malaria is endemic. The current incidence rate is 0.74‰ inhabitants, and Plasmodium vivax is widely predominating even though Plasmodium falciparum is still present due to imported cases mainly from Africa. In FG, rapid diagnostic test (SD Malaria Ag P.f/Pan®) is based on the detection of pan-pLDH, PfHRP2, and PfHRP3 antigens, while in South America, the share of deletion of PfHRP2 gene is significantly increasing. Accordingly, the study questions the reliability of RDTs in the Amazonian context. Methods The study is retrospective. It is conducted over 4 years and analysed 12,880 rapid diagnostic tests (RDTs) compared to concomitant Blood Film Tests (BFTs) sampled for malaria diagnosis. Results The global assessment of the accuracy of SD Malaria Ag P.f/Pan® in the diagnostic of malaria shows both Positive and Negative Predictive Values (PPV and NPV) higher than 95%, except for PPV in the diagnosis of malaria to P. falciparum (88%). Overall, the concordance rate between RDT and BFT (positive/positive; negative/negative) was 99.5%. The PPV of the RDT in the follow-up of patients diagnosed with P. falciparum was the lowest during the first 28 days. The PPV of the RDT in the follow-up of patients diagnosed with P. vivax was the lowest during the first 21 days. The global sensitivity of SD Malaria Ag P.f/Pan® test was, on average, 96% (88.2–100) for P. falciparum and 93% (90.6–94.2) for P. vivax. The global specificity was 99.8% (99.5–100) for all included species. Conclusion SD Malaria Ag P.f/Pan® is a reliable rapid test used for the first-line diagnosis in remote healthcare centres. The test results should be interpreted in the light of patient’s recent medical history and the date of arrival to FG.

scholarly journals Comparative Performance Evaluation of Routine Malaria Diagnosis at Ho Municipal Hospital

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
James Osei-Yeboah ◽  
Gameli Kwame Norgbe ◽  
Sylvester Yao Lokpo ◽  
Mohammed Khadijah Kinansua ◽  
Loverage Nettey ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Gold Standard ◽  
Malaria Diagnosis ◽  
Diagnostic Methods ◽  
Youden Index ◽  
Operating Characteristics ◽  
Presumptive Diagnosis ◽  
Comparative Performance ◽  
Cross Sectional

Differences in quality performance score had been reported for the routinely used diagnostic methods for malaria at different settings. There is therefore a need to evaluate the test performance of the routine diagnostic methods for malaria detection in Ho, a setting with no recorded quality evaluation on malaria diagnosis. The hospital-based cross-sectional study was conducted comprising 299 outpatients. Patients were first seen and presumptively diagnosed with malaria by a clinician and were referred to the laboratory for confirmation (microscopy and Rapid Diagnostic Test). The performance analysis included sensitivity, specificity, receiver operating characteristics (ROC), weighted kappa, Youden index, andpvalue. Out of the 299 patients, 221 patients were positive by presumptive diagnosis, 35 were positive by Rapid Diagnostic Test (RDT), and 25 were positive by microscopy. Using microscopy as the gold standard, RDT had sensitivity of 62.5% and specificity of 92.73%, whilst presumptive diagnosis had a sensitivity of 70.83% and specificity of 25.82%. The RDT recorded ROC of 0.697 withpvalue of 0.0001. The presumptive diagnosis recorded ROC of 0.506 withpvalue of 0.7304. Though none of the test methods evaluated over the gold standard achieved the WHO recommended diagnostic sensitivity and specificity, the RDT achieved an acceptable agreement with the gold standard.

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