Comparative Assessment of Some Rapid Diagnostic Test (RDT) Kits for Malaria Diagnosis in Ibadan, Nigeria

Abstract

Background:  Deployment of sound diagnostic deliverables remains a crucial component of malaria control and prevention programme in Africa. This study aims to make a comparative assessment of the efficacy of three famous brands of rapid diagnostic kits (RDT) available in Nigerian market, with the traditional Giemsa staining (microscopic) method, in testing for malaria in endemic zones, also to provide relevant information and guidance to individuals, health care service providers, test kit manufacturers as well as health corporate organizations.

Methods: Giemsa microscopy along with RDT kits (Acon, Paracheck and SD Bioline) were carried out on 525 patient samples presumed to present with acute uncomplicated malaria by clinical diagnosis. In addition, the total WBC count and haematocrit were conducted on the blood samples.

Results: Out of the 525 samples recruited, three hundred (300) 57.1% were found positive by Giemsa microscopy. SD Bioline had a positivity rate of 260 (49.5%) while Acon and Paracheck trailed behind with 200 (38.1%) and 150 (28.6%) samples respectively. The sensitivity, specificity and efficiency of the three RDT kits were as follows: SD Bioline (86.3%, 99.6%, 92%); Paracheck (50%, 97.7%, 70.4%) and Acon (66.7%, 100%, 80.9%) respectively. Children within the age bracket 0-10 years had the highest malaria positivity rate (F=5.29; p< 0.05). 115 (38.3%) of children in this age group were positive for malaria with Mean PCV of 30.65 ± 0.52 compare to non-malaria control. The dominant malaria species was P. falciparum with 280 (93.3%) cases. However, an appreciable cases of P. falciparum & P. vivax 15 (5.0%) along with P. falciparum & P. malariae 5 (1.7%) co-infections were confirmed. It was also observed that the haematocrit value for individuals correlated inversely with the parasite density (r = -0.78; p< 0.05).

Conclusion and Recommendation: Giemsa microscopy method still remains the gold standard for malaria diagnosis in limited resources endemic zones and recommends that imported RDT kits for malaria should be validated before use in developing countries.

Keywords: Giemsa Microscopy; Rapid Diagnostic Kits; Parasite Density; Co-Infection; Malaria Control