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Diagnosis of malaria is a fundamental component of malaria case management. Parasitological confirmation of malaria before treatment was recommended for endemic countries. Microscopy diagnosis of malaria, the gold standard as constraints such as: level of expertise, quality of equipment and reagents may lead to misdiagnosis. The histidine rich protein 2 (HRP-2) based rapid diagnostic test (RDT) detects Plasmodium falciparum only. We therefore evaluated the performance of malaria HRP-2 rapid tests among febrile patients suspected to have malaria in Iwo, Osun state Nigeria. A cross-sectional study was conducted on patients with fever or symptoms suggestive of malaria at the Outpatient’s Department of a University Medical Centre in Iwo, Osun State, Nigeria. Malaria diagnosis was performed with the malaria HRP-2-based RDT and microscopy for every participant. Stained Thick and thin films prepared on the same slide, stained with 3% Giemsa stain and evaluated for detection, speciation and parasite density per patient.. Malaria RDT results were read as positive or negative. Of the 289 febrile patients assessed between October 2016 to August 2017, the number positive by Malaria RDT and microscopy were 102 (35.3%) and 98 (33.9%) respectively. Parasite density ranged from 76 p/μL to 165,333p/μL of blood. Overall, the sensitivity, specificity, positive and negative predictive values were: 96.08%, 97.95%, 96.08% and 97.95% respectively. This study showed malaria RDT could be a reliable option to microscopy for effective case management of uncomplicated falciparum malaria in febrile patients in Iwo, Nigeria.

Performance Evaluation of Malaria HRP-2 Rapid Diagnostic Test among Febrile Patients with Malaria in Iwo, Osun State, Nigeria