Efficacy of Plasmodium falciparum histidine-rich protein 2 (Pfhrp 2) rapid diagnostic test (RDT) and microscopy in the detection of falciparum malaria among symptomatic patients in Akure, Nigeria

ABSTRACT

@#Accurate diagnosis and prompt treatment are highly essential in the management of malaria, which is one of the deadliest infectious diseases worldwide, particularly in tropical and sub-tropical regions including Nigeria. This study was designed to evaluate the efficacy of malaria histidine-rich protein 2-based rapid diagnostic test (RDT) and microscopy in the diagnosis of falciparum malaria in Nigeria. This was a cross-sectional and hospital-based study. The standard method of microscopy was used as the gold standard. Giemsa stained thick and thin smears were prepared to count and detect malaria parasite species. Also, a malaria histidine-rich protein 2-based RDT was used to detect malaria parasites and diagnostic efficacy were determined through the measure of sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), diagnostic accuracy and Youden Index (J). The result showed that out of the total 303 individuals examined, a total malaria prevalence of 67.0% and 68.0% were recorded for microscopy and RDT, respectively. Additionally, the sensitivity (95% C.I), specificity (95% C.I), PPV (95% C.I), and NPV (95% C.I) of RDT compared to microscopy were 97.54 (94.36-98.94), 92.00 (85.00-95.89), 96.12 (92.53-98.02), and 94.85 (88.50- 97.78), respectively. The diagnostic accuracy (95% C.I) and Youden Index (J) were 95.71 (92.77- 97.70) and 0.89, respectively. Conclusively, our study revealed that RDT continues to remain efficacious. Thus, while malaria diagnosis by microscopy which is the gold standard remains the major method of malaria detection, it should be complemented by rapid diagnostic test (RDT), particularly in high malaria endemic regions where mean parasite density of patients are usually high.