The performance of an Histidine rich protein-2 rapid diagnostic test (RDT) against the standard microscopy in the diagnosis of malaria parasitaemia among febrile under-five children at Nnewi

Abstract

Background: Malaria remains a major cause of morbid-ity and mortality, thus there is need for quick, reliable inexpen-sive diagnostic tool to facilitate its prompt treatment especially in resource poor settings. Objectives: To compare the sensi-tivity of a locally available His-tidinerich protein-2 based rapid diagnostic test (RDT) with the standard microscopy. Methods: This study was carried out to test the performance of an histidine rich protein -2 rapid di-agnostic test (RDT) against the standard microscopy in the diag-nosis of malaria among febrile under-five children attending Paediatric Clinic of NAUTH Nnewi. A total of 200 children under the age of five years were recruited for the study. Data on socio-demographic characteristics and symptoms were collected through an interviewer adminis-tered questionnaire. Blood sample was collected in EDTA bottle after observing universal precau-tions. All of them were tested with both Giemsa stained blood smear and Histidine rich protein-2 (HRP-2) rapid diagnostic test (RDT). Results: There were 118 males and 82 females, giving a male: female ratio of 1.44:1. Their ages ranged from 3-59 months and the average age was 27+17.49 months. Aver-age number of days the subjects had fever before presentation were 3.78+1.95 days with a range of 1-14 days. Body temperature ranged from 35.9-40.4 0 C with av-erage of 37.7+0.8 0 C. Forty (20%) were positive by microscopy while 42 (21%) were positive by rapid diagnostic test. Twenty-percent of those positive by microscopy (n=8) were negative by RDT while 23.8% of those positive by RDT (n=10) were negative by micros-copy. Using microscopy as a gold standard, the sensitivity of the RDT was 80%, the specificity was 93.8%. The positive and negative predictive values were 76.2% and 94.9% respectively. Conclusion: Based on these find-ings, the RDT demonstrated rea-sonable concordance with micros-copy and was recommended for use at every level of healthcare in the diagnosis of malaria.