Agbor Neji Ebuta^1,2*, Lawrence Akin-Moses³, Adamu Onu², Nathan Ukuoghene Ikimi¹, Victoria Ogala-Akogwu¹

¹State House Medical Center, Asokoro, Abuja, Nigeria
²Garki Hospital Abuja, Nigeria
³National Hospital Abuja, Nigeria

*Corresponding Author: Agbor Neji EBUTA, State House Medical Center, Abuja, Nigeria.

Received: April 27, 2023; Published: June 09, 2023

Abstract

Background: Malaria is a major global public health challenge. Diagnosis is a critical link to mitigating its impact. New malaria diagnostic methods that simplify malaria testing, might improve acceptance, access to tests, and compliance with the test before treatment policy of WHO. While microscopy and RDT are established, UMT is novel and merits further evaluation.

Methods: This was a cross-sectional diagnostic test study, 262 children with presumptive malaria were recruited. All were tested with the three methods: microcopy, RDT, and UMT.

Results: The prevalence of malaria using microscopy, RDT, and UMT test methods were 33.59% (88), 20.99% (55), and 2.67% (7) respectively. Only fathers’ educational status showed a significant association with malaria test outcomes (i.e., positive or negative). The sensitivity of RDT was 29.5%, and its specificity was 83.3%. It’s positive predictive and negative predictive values were 47.3% and 70% respectively. UMT recorded a sensitivity of 4.5% and specificity of 98.3%, while its positive predictive and negative predictive values were 57.1% and 67.1% respectively.

Conclusion: The UMT, though preferred by the patient’s guardians, had lower sensitivity and specificity compared to microscopy and RDT. More research is still needed to make UMT robust for clinical practice use.

 Keywords: Malaria; Giemsa Microscopy; Rapid Diagnostic Test; Urine Malaria Test Kits

References

1. Mins. of Health, National Guidelines for Diagnosis and Treatment of Malaria, 4^th ed. NMEP, (2020).
2. J Okete., et al. “Reliability of Urine Malaria Test (UMT) for Malaria Diagnosis”. AJRIMPS1 (2018): 1-9.
3. M Peter Asaga., et al. “Prevalence of Plasmodium Falciparum among Nigerians in Abuja and Central States: A Comparative Analysis of Sensitivity and Specificity Using Rapid Diagnostic Test and Microscopy as Tools in Management of Malaria”. International Journal of Tropical Diseases 1 (2019).
4. T Oguonu., et al. “The performance evaluation of a urine malaria test (UMT) kit for the diagnosis of malaria in individuals with fever in south-east Nigeria: cross-sectional analytical study”. Malaria Journal1 (2014): 403.
5. W A Oyibo., et al. “Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria”. Journal of Clinical Microbiology 1 (2017): 253-263.
6. World Health Organization, Malaria microscopy quality assurance manual, Version 2. Geneva: World Health Organization (2016).
7. A Moody. “Rapid Diagnostic Tests for Malaria Parasites”. Clinical Microbiology Reviews 1 (2002): 66-78.
8. J Cunningham., et al. “A review of the WHO malaria rapid diagnostic test product testing programme (2008-2018): performance, procurement and policy”. Malaria Journal1 (2019): 387.
9. Nigeria Malaria Indicator Survey 2015: Final Report. NMEP, (2016).
10. A G Samal., et al. “The sensitivity and specificity of a urine based Rapid Diagnostic Test for the diagnosis of plasmodium falciparum in a malaria endemic area in Odisha, India”. Pathogens and Global Health7 (2017): 383-387.
11. J Chan., et al. “Patterns of protective associations differ for antibodies to falciparum ‐infected erythrocytes and merozoites in immunity against malaria in children”. European Journal of Immunology 47.12 (2017): 2124-2136.
12. D L Doolan., et al. “Acquired Immunity to Malaria”. Clinical Microbiology Reviews 1 (2009): 13-36.
13. M Pinkevych., et al. “The Dynamics of Naturally Acquired Immunity to Plasmodium falciparum Infection”. PLOS Computational Biology 10 (2012): e1002729.
14. E I Nwaneli., et al. “Malaria Prevalence and its Sociodemographic Determinants in Febrile Children- a Hospital-based Study in a Developing Community in South-east Nigeria.”. Journal of Preventive Medicine and Hygiene (2020): E173.
15. U Dalrymple., et al. “How long do rapid diagnostic tests remain positive after anti-malarial treatment?”. Malaria Journal1 (2018): 228.
16. MN Wogu and F O Nduka. “Evaluating Malaria Prevalence Using Clinical Diagnosis Compared with Microscopy and Rapid Diagnostic Tests in a Tertiary Healthcare Facility in Rivers State, Nigeria”. Journal of Tropical Medicine (2018): 1-4.
17. I T Nzekwe., et al. “Comparative evaluation of diagnostic accuracies of three rapid malaria testing kits”.
18. J Iqbal., et al. “Plasmodium falciparum Histidine-Rich Protein 2-Based Immunocapture Diagnostic Assay for Malaria: Cross-Reactivity with Rheumatoid Factors”. Journal of Clinical Microbiology 3 (2000): 1184-1186.
19. P Gillet., et al. “False Positivity of Non-Targeted Infections in Malaria Rapid Diagnostic Tests: The Case of Human African Trypanosomiasis”. PLOS Neglected Tropical Diseases 4 (2013): e2180.
20. P Pati., et al. “High proportions of pfhrp2 gene deletion and performance of HRP2-based rapid diagnostic test in Plasmodium falciparum field isolates of Odisha”. Malaria Journal1 (2018): 394.
21. U I Ugah., et al. “Evaluation of the utility value of three diagnostic methods in the detection of malaria parasites in endemic area”. Malaria Journal1 (2017): 189.

Citation

Citation: Agbor Neji Ebuta., et al. “A Comparison of Blood Smear Microscopy, Rapid Diagnostic Test (RDT), and Urine Malaria Test (UMT) for the Diagnosis of Malaria in Children Aged ≤ 5 Years”.Acta Scientific Medical Sciences 7.7 (2023): 26-33.

Copyright

Copyright: © 2023 Agbor Neji Ebuta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.