Utility of Rapid Diagnostic Tests for Detection of Malarial Antigens and Their Comparison with Peripheral Blood Smear Examination.

ABSTRACT

Malaria, sometimes called the “king of diseases” is caused by protozoan parasites of the genus Plasmodium. The disease is transmitted by nine Anopheline species out of which six are primary vectors. This hospital based descriptive study aimed to determine the diagnostic accuracy of rapid antigen detection tests for diagnosis of malaria by immunochromatography (ICT) as compared to microscopic examination for detection of malarial parasites by Leishman, Field’s and Giemsa stains.METHODSThis study was undertaken in the Department of Microbiology and samples were collected from December 2017 to November 2018. Patients with fever without any history of treatment with antimalarials were included in this study. A total of 200 blood samples were collected and subjected to microscopy and ICT by three different commercially available kits. Stains used for staining thick and thin smears were acquired from HiMedia (Mumbai).RESULTSOut of the 200 patients, 128 (64.0%) were male and 72 (36.0%) were females. Maximum number of cases were from the Department of Medicine 57.0% followed by the Department of Paediatrics 32.5%. Majority of the cases were seen in the post monsoon season 31.5% followed by summer and monsoon season 29.0% and 55/200 respectively. Least number of cases were seen in winter 12.0%. ICT was positive in 26% of cases and 24% were positive on microscopy. Plasmodium vivax infection was seen in 60%, Plasmodium falciparum was seen in 33 % and 7% had mixed infection. Positivity of Giemsa, Leishman and Field’s stain was found to be 24%, 22.5% and 15.6% respectively. Positivity of Parahit total, Paramax 3 and Is It Medsource was found to be 26%, 24% and 14.5% respectively.CONCLUSIONSMalaria is still a major public health concern. In this study, Plasmodium vivax was more common. Sensitivity of ICT was found to be better than microscopy. This study gives a basic insight about malaria and the problems associated with its diagnosis in a rural setup.