Performance Characteristics of Malaria Rapid Diagnostic Test and Its Utilization in Management of Febrile Patients in Korogwe District (Tanga) Tanzania

Abstract

Background: Malaria diagnosis continues to be the foremost among the challenge in malaria control strategies in Sub-Saharan countries including Tanzania. The World Health Organization changed malaria treatment Guidelines in 2010 to restrict the use of antimalarial drugs to parasitologically confirmed malaria cases in response to the overuse of antimalarial drugs. Malaria rapid diagnostic tests (mRDTs) are presented as a mean to implement the new guidelines for malaria parasitologically confirmed cases prior to initiating antimalarial drug therapy for mRDT positive patients. Methods: A hospital-based cross-sectional study among patients with fever and malaria-like symptoms was done between May and June, 2014 in Korogwe district hospital in a convenient manner. Data were cleaned and analysed in Epi-Info version 3.5.4 computer software, Chi-square test was used to compare proportions between two groups with P-value set at 0.05. Results: Results revealed that sensitivity, specificity, positive predictive value and negative predictive value of mRDT at 95% CI was 97.6%, 97.4%, 91.0% and 99.3% respectively. All patients with positive mRDT were treated with antimalarial drugs, while patients with negative mRDT results were treated with either antimalarial (P-value = 0.001) or antibiotics (P-value = 0.005) at 95% CI. The results of patients with negative mRDT results were less likely to be further investigated at 95% CI (P-value = 1.000). Conclusion: The mRDT had good sensitivity and specificity if compared with blood slide microscopy. Clinicians adhered to the 2010 World Health Organization guidelines adopted by the National Malaria Control Programme for patients with positive mRDT result; however, they did not adhere to malaria diagnosis and management guidelines in case of negative mRDT results.