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Diagnostic performance of rapid diagnostic tests for the diagnosis of malaria at public health facilities in north‐west E thiopia
Author(s) -
Getnet Gebeyaw,
Getie Sisay,
Srivastava Mitaly,
Birhan Wubet,
Fola Abebe A.,
Noedl Harald
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12570
Subject(s) - malaria , plasmodium ovale , medicine , rapid diagnostic test , diagnostic test , plasmodium falciparum , nested polymerase chain reaction , public health , plasmodium vivax , diagnosis of malaria , immunology , virology , veterinary medicine , polymerase chain reaction , biology , pathology , biochemistry , gene
Objective To assess the performance of RDT s against nested polymerase chain reaction ( nPCR ) for the diagnosis of malaria in public health facilities in north‐western E thiopia. Methods Cross‐sectional study at public health facilities in N orth G ondar, E thiopia, of 359 febrile patients with signs and symptoms consistent with malaria. Finger prick blood samples were collected for testing in a P . falciparum /pan‐malaria RDT s and for molecular analysis. Sensitivity, specificity and predictive values were determined for the RDT s using nPCR as reference diagnostic method. Kappa value was determined to demonstrate the consistency of the results between the diagnostic tools. Results By RDT s, 22.28% (80/359) of patients tested positive for malaria, and by nPCR , 27.02% (97/359) did. In nPCR , 1.67% (6/359) and 0.28% (1/359) samples were positive for P . ovale and P . malariae , which had almost all tested negative in the RDT s. The sensitivity, specificity, positive and negative predictive values of RDT s for the diagnosis of malaria were 62.9%, 92.7%, 76.3% and 87.1%, respectively, with 0.589 measurement agreement between RDT s and nPCR . The sensitivity and specificity of RDT s for P . falciparum identification only were 70.8% and 95.2%, and 65.2% and 93.1% for P . vivax . Conclusion Although RDT s are commonly used at health posts in resource‐limited environments, their sensitivity and specificity for the detection and species identification of Plasmodium parasites were poor compared to nPCR , suggesting caution in interpreting RDT s results. Particularly, in the light of expanded efforts to eliminate malaria in the country, more sensitive diagnostic procedures will be needed.