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

• Main Authors: Oluwagbenga Ogunfowokan, Bamidele A. Ogunfowokan, Anthony I. Nwajei
• Format: Article
• Language: English
• Published: AOSIS 2020-06-01
• Series: African Journal of Primary Health Care & Family Medicine
• Subjects: family medicine; primary care; education; mrdt; parasite density; sensitivity; specificity
• Online Access: https://phcfm.org/index.php/phcfm/article/view/2212

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.