A comparison of thick smears, QBC malaria, PCR and PATH falciparum malaria® test trip in Plasmodium falciparum diagnosis

Abstract

Blood samples from 182 patients presenting at the out-patient clinic in Richard-Toll, Senegal were analysed by Thick smear microscopy, the QBC, PCR and the new dipstick PATH Malaria® assay which detects the histidine rich protein II antigen of Plasmodium falciparum. Thick smear microscopy was used as the reference method. Sensitivity, specificity, predictive positive and negative values were 100 %, 83.6 %, 93.4 % and 100 % for QBC respectively; 100 %, 72.7 %, 89.4 % and 100 % for PCR; 96 %, 92.7 %, 96.8 % and 91 % for the PATH assay. PATH assay failed to detect one positive sample with Plasmodium malariae. Assays were also compared with regard to the expense of equipment and reagents and speed and ease of use. The rapid PATH assay can be performed with minimal training and may be specially useful in areas where P. falciparum is the predominant malaria species, in epidemic malaria regions, and where skilled microscopy is not readily available.