scholarly journals Mentorship on malaria microscopy diagnostic service in Ethiopia: Baseline competency of microscopists and performance of health facilities

2021 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Microscopic Diagnosis ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria cases are declining as a result of proven interventions and in 2017, the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 1st to September 30th, 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 the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, the sensitivity, the specificity, and the 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 re-checking 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 the detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, a 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 Mentorship on malaria microscopy diagnostic service in Ethiopia: Baseline competency of microscopists and performance of health facilities

2021 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Microscopic Diagnosis ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria cases are declining as a result of proven interventions and in 2017, the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 1st to September 30th, 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 the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, the sensitivity, the specificity, and the 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 re-checking 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 the detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, a 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 Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Microscopic Diagnosis ◽  
Malaria Microscopy

Abstract Background In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. Methods A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 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 a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. Results In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 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 re-checking 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 the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a 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. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy.

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.

Assessment of the Accuracy of Malaria Microscopy in Private Health Facilities in Entebbe Municipality, Uganda; A Cross-sectional Study

2021 ◽  
Author(s):  
Tobius Mutabazi ◽  
Emmanuel Arinaitwe ◽  
Alex Ndyabakira ◽  
Emmanuel Sendaula ◽  
Alex Kakeeto ◽  
...  
Keyword(s):  
Predictive Value ◽  
Malaria Diagnosis ◽  
Clinical Information ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Factors Associated ◽  
Expert Microscopy ◽  
Malaria Microscopy

Abstract Introduction: Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. We evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda.Methods: Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results: The prevalence of malaria parasitemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1% and 99.2% respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; 1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [OR] = 9.74, 95% Confidence Interval [CI] (1.06 – 89.5), p-value=0.04), and 2) who was examining less than 5 smears a day (OR = 38.8, 95% CI 9.65- 156, p-value <0.001).Conclusion: The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector.

scholarly journals Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tobius Mutabazi ◽  
Emmanuel Arinaitwe ◽  
Alex Ndyabakira ◽  
Emmanuel Sendaula ◽  
Alex Kakeeto ◽  
...  
Keyword(s):  
Predictive Value ◽  
Malaria Diagnosis ◽  
Clinical Information ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Factors Associated ◽  
Expert Microscopy ◽  
Malaria Microscopy

Abstract Background Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. Methods Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06–89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65–156, p-value < 0.001). Conclusions The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.

scholarly journals Sensitivity and Specificity of Sheard and Percival’s Criteria for the Diagnosis of Young People with Near-heterophoria

2021 ◽  
Vol 9 (B) ◽  
pp. 1128-1134
Author(s):  
Saif Hassan Alrasheed ◽  
Amel Mohamed Yousif ◽  
Majid A. Moafa ◽  
Abd Elaziz Mohamed Elmadina ◽  
Mohammad Alobaid
Keyword(s):  
Young People ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Binocular Vision ◽  
Predictive Value ◽  
High Sensitivity ◽  
The Other ◽  
Cross Sectional ◽  
Predictive Values ◽  
Low Sensitivity

BACKGROUND: Sheard and Percival assumed that symptoms from latent strabismus can be avoided if the relevant fusional vergence is adequate to support the heterophoria. AIM: The aim of the study was to determine the sensitivity and specificity of Sheard’s and Percival’s criterion for the diagnosis of heterophoria. METHODS: A cross-sectional hospital-based study was performed at Al-Neelain Eye Hospital Khartoum, Sudan from February to October 2019. Heterophoria was measured using Maddox Wing and fusional vergence using a prism bar. Thereafter, Sheard’s and Percival’s criteria were used for the diagnosis of heterophoria. RESULTS: A total of 230 participants (age = 15–30 years; mean age = 19.34 ± 3.325 years) were recruited for this study. The Sheard’s criteria showed a high sensitivity of 87.2% and a low specificity of 8.0% for the diagnosing of exophoria, with positive and negative predictive values of 65.5% and 26%, respectively. The criteria showed a relatively low sensitivity of 77.8% and a specificity of 9.0% in the diagnosis of esophoria, with a positive and negative predictive values of 56% and 20%, respectively. Percival criteria showed high sensitivity 84.2% and low specificity 9.1% in diagnosing esophoria, with a positive and negative predictive value of 61.5% and 25%, respectively. On the other hand, the criteria showed low sensitivity 67.4% and specificity 13.8% in diagnosing exophoria, with positive and negative predictive value 61.9% and 17%, respectively. CONCLUSION: Sheard’s and Percival’s criteria are useful in diagnosing binocular vision problems. Sheard’s criteria are accurate in diagnosing near exophoria and Percival’s criteria are more accurate in diagnosing near esophoria. Therefore, these criteria provide good clues and predictions for the diagnosis of binocular vision problems.

scholarly journals Sensitivity and specificity of malaria rapid diagnostic test (mRDT CareStatTM) compared with microscopy amongst under five children attending a primary care clinic in southern Nigeria

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Oluwagbenga Ogunfowokan ◽  
Bamidele A. Ogunfowokan ◽  
Anthony I. Nwajei
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Parasite Density ◽  
Primary Care Clinic ◽  
Malaria Diagnosis ◽  
Malaria Prevalence ◽  
Cross Sectional ◽  
Care Clinic ◽  
Predictive Values

Background: Malaria diagnosis using microscopy is currently the gold standard. However, malaria rapid diagnostic tests (mRDTs) were developed to simplify the diagnosis in regions without access to functional microscopy.Aim: The objective of this study was to compare the diagnostic accuracy of mRDT CareStatTM with microscopy.Setting: This study was conducted in the paediatric primary care clinic of the Federal Medical Centre, Asaba, Nigeria.Methods: A cross-sectional study for diagnostic accuracy was conducted from May 2016 to October 2016. Ninety-eight participants were involved to obtain a precision of 5%, sensitivity of mRDT CareStatTM of 95% from published work and 95% level of confidence after adjusting for 20% non-response rate or missing data. Consecutive participants were tested using both microscopy and mRDT. The results were analysed using EPI Info Version 7.Results: A total of 98 children aged 3–59 months were enrolled. Malaria prevalence was found to be 53% (95% confidence interval [CI] = 46% – 60%), whilst sensitivity and specificity were 29% (95% CI = 20% – 38%) and 89% (95% CI = 83% – 95%), respectively. The positive and negative predictive values were 75% (95% CI = 66.4% – 83.6%) and 53% (95% CI = 46% – 60%), respectively.Conclusion: Agreement between malaria parasitaemia using microscopy and mRDT positivity increased with increase in the parasite density. The mRDT might be negative when malaria parasite density using microscopy is low.

Performance of Malaria Microscopy External Quality Assessment and networking among Health Facilities in West Amhara Region, Ethiopia

2020 ◽  
Author(s):  
Banchamlak Tegegne ◽  
Kefale Ejigu ◽  
Getaneh Alemu ◽  
Yeshimebet Fetene ◽  
Kindye Endaylalu ◽  
...  
Keyword(s):  
Microscopic Examination ◽  
False Positive ◽  
False Negative ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Reference Laboratory ◽  
Amhara Region ◽  
Good Test ◽  
Cross Sectional ◽  
Malaria Microscopy

Abstract Background: In most health facilities, microscopic examination of peripheral blood smears is performed for definitive diagnosis of malaria. Despite it produces reliable results about both the infection status and level of parasitemia, microscopic examination of malaria is affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous monitoring of the performance of laboratories is critical in order to make timely corrections. Objective: To assess malaria microscopy performance of diagnostic laboratories in west Amhara region.Methods: A facility based cross-sectional study was conducted from July 2017 to July 2019 among thirty malaria diagnostic laboratories in west Amhara region. Thirty slides were collected from participating laboratories every quarter. Collected slides were taken to Amhara Public Health Institute (APHI) reference laboratory and re-checked by malaria microscopist who were blind to the results from health facilities. Percentage of test agreement, rates of false positive, false negative and species misdiagnosis were calculated using Excel 2010.Results: Among a total of 6689 slides re-examined, results of 6146 slides were the same with that of participating laboratories to give a test agreement of 97.31% and 94.6% in parasite detection and species identification, respectively. Variations in the overall performance of individual laboratories were seen within a range of 81.55% to 97.27% test agreement. Results of 543 (8.12%) slides were discordant, of which 363 (5.4%), 93 (1.4%) and 87 (1.3%) were due to species misdiagnosis, false positive and false negative results, respectively. Conclusion: There was good test agreement between participated laboratories and APHI laboratory. More accurate performance is expected as the country is tracking to malaria elimination. Hence, strengthening the EQA program by integrating rechecking with onsite evaluation is recommended.K

scholarly journals Pre-Procedural Surveillance Testing for SARS-CoV-2 in an Asymptomatic Population Shows Low Rates of Positivity

2020 ◽  
Author(s):  
James A Mays ◽  
Alexander L Greninger ◽  
Keith R Jerome ◽  
John B Lynch ◽  
Patrick C Mathias
Keyword(s):  
Positive Predictive Value ◽  
Beck Depression Inventory ◽  
Predictive Value ◽  
Total Population ◽  
False Negative ◽  
Self Report ◽  
Case Group ◽  
Cross Sectional ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Depression is a common cause of mortality and morbidity worldwide. To detect depression, we compared Beck Depression Inventory scoring as a valid tool with participants self-reporting depression.Methodology: This cross-sectional study aimed to explore the diagnostic values of self-reporting in patients' with depression comparing to Beck Depression Inventory scoring in Mazandaran Persian cohort study, with a total of 1300 samples. The sample size was determined to include 155 participants through the census method. In order to increase the test power, 310 healthy participants were included in the study through random selection. In order to evaluate the diagnostic value of self-reporting, BDI-II was completed by blind interviewing to the case group as well as to another group who reported that they were not depressed, as control.Results: sensitivity, specificity, accuracy, false positive, false negative, positive and negative predictive values of self-reporting was calculated 58.4%, 79.1%,73.4%, 20.8%, 41.6%, 51.8%, and 83.2% for the total population respectively, as well as, sensitivity, specificity, accuracy, positive and negative predictive values of self-report in males were 83.3%, 77.2%, 77.1%, 43.8% and 95.6% and 53.7%, 78.1%, 71.2%, 49.2%, and 81.1% for females, respectively.Conclusion: The positive predictive value and sensitivity of self-reporting are insufficient in total population and females, and therefore self-reporting cannot detect depressed patients, but regarding to its average positive predictive value, perhaps, it can be used to identify non-depressant individuals.

Performance of PfHRP2 and PfPLDH Rapid Diagnostics Test for Diagnosis of Plasmodium falciparum in Assosa Zone, Northwest Ethiopia

2020 ◽  
Author(s):  
Gezahegn Solomon Alemayehu ◽  
Karen Lopez ◽  
Cheikh Dieng ◽  
Eugenia Lo ◽  
Daniel Janies ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Predictive Value ◽  
False Negative ◽  
Reference Method ◽  
Malaria Diagnosis ◽  
Northwest Ethiopia ◽  
Blood Film ◽  
Limited Information ◽  
Rapid Diagnostics ◽  
Cross Sectional

Abstract Background Malaria is a life-threatening infectious disease particularly due to Plasmodium falciparum (P.falciparum ). Plasmodium falciparum Histidine-Rich Protein 2 (PfHRP-2) and Plasmodium falciparum specific Lactate Dehydrogenase (PfPLDH) based rapid diagnostic test are commonly used for malaria diagnosis in malaria endemic countries where microscopic examination is scarce. However, there is limited information on the performance of malaria RDT in rural and semi urban area of Assosa zone, Northwest Ethiopia. Thus, the aim of this study is to determine the performance of PfHRP2 and PfPLDH RDT for diagnosis of falciparum malaria against microscopy as reference method. Methods Health-facility based cross-sectional study design was conducted in Assosa zone, Northwest Ethiopia from November to December 2018. A total of four hundred and six malaria-suspected participants attending Bambasi, Sherkole, Kurmuk and Assosa health-centers were tested. Finger-prick blood samples were collected for microscopy blood film preparation, RDTs and molecular diagnosis. Statistical analyses were performed using SPSS version 20. Results Of the total study participants, 26.4% (107/406) were microscope confirmed P. falciparum positive. Using PfHRP2 and PfPLDH RDT, 30.3% (123/406) and 24.1% (98/406) were positive for P. falciparum, respectively. The sensitivity of PfHRP2 and PfPLDH was 96% and 89%, respectively, against microscope. The corresponding specificity rates of PfHRP2 and PfPLDH were 93% and 99%, respectively. Similarly, positive predictive value (PPV) and negative predictive value of PfHRP2 and PfPLDH RDT were 84%, 97%, 99% and 96%, respectively. There was an agreement between RDTs (PfPLDH and PfHRP2) and reference microscopy method with a kappa value of 0.86 and 0.90, respectively. Compared to qPCR, the specificity of PfHRP2 (93%) and PfPLDH RDT (98%) were high, though the respective sensitivity of PfHRP2(77%) and PfPLDH RDT(70%) were low. Conclusion PfHRP2 and PfPLDH showed reasonable agreement in detecting P. falciparum infections. Hence, currently used national malaria RDT kit can be continue to be used in certain malaria endemic areas in Ethiopia. However, Continuous monitoring the performance of PfHRP-2 RDT associated with false negative results is important to consider an alternative malaria RDT like PfPLDH RDT to support control and elimination of malaria in Ethiopia

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