Malaria—Case Management in Lagos, Nigeria, With SD–BIOLINE HRP-2–Based RDTS

Abstract

and 565 (79%) tested negative, 342 of whom were sent for confirmatory culture. Only one of the 342 negative cases was positive by culture. Sensitivity is calculated as 99.3% with a negative predictive value of 99.7%. Conclusions: Our results show that molecular POCT is an excellent screening method for GAS in a population of both adults and children. There was only one false negative in the cases with confirmatory cultures, suggesting that these cultures may not be required. Larger studies may be needed to determine whether the high sensitivity and negative predictive values are stable with a solely pediatric population. Objectives: This study was carried out to evaluate the performance characteristics of SD Bioline HRP-2 RDT in malaria case management using microscopy as a gold standard among patients at a primary health care center in Lagos, Nigeria. Methods: Study comprised 1,276 consenting patients who were randomly selected from the outpatient department of a primary health center in the community. Venous blood samples of patients were collected and screened for malaria parasite infection using microscopy and SD Bioline HRP-2 RDT diagnostic methods. An analysis was performed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of the SD Bioline HRP-2 RDT. Patients were administered with a case report form. Results: Among 1,276 patients recruited for the study, only 197 (15.4%) and 186 (14.6%) were positive for P falciparum by HRP-2 RDT and microscopy (P > .05). The sensitivity, specificity, positive predictive value, and negative predic-tive values were 94%, 98.5%, 91.4%, and 98.2%, respectively. Using RDT to correlate symptoms, afebrile fever recorded the highest in all age groups (810, 63%), while febrile fever with temperature ≥37°C recorded 229 (17.9%) in all age groups; 45.8% (584) of the patients had access to medication. Conclusion: SD Bioline HRP-2 RDT is reliable for parasite based diagnosis of malaria infection but unreliable for correlating symptoms of malaria, especially fever with parasite identification.