Evaluation of malaria prevalence using microscopic examination and histidine

Malaria is a disease of severe public health importance and Nigeria suffers the world’s greatest malaria burden. This hospital-based study was designed to comparatively evaluate malaria prevalence using microscopy and Rapid Diagnostic Test (RDT) in Anambra, Nigeria. Four hospitals in Awka, Anambra state were chosen for the study. Blood samples of 322 patients who attended the hospitals were examined for malaria parasite infection using both Giemsa-stained thick film microscopy and Histidine-rich protein 2 Rapid Diagnostic Kit. Results showed Of the 322 patients enrolled, 194 (60.2%) tested positive by microscopy and 199 (61.8%) by RDT. Utilizing microscopy as the gold standard, the RDT showed a high sensitivity and specificity value of 100% and 96.1% respectively. The positive predictive value (PPV) of this diagnostic method was 97.5% while the negative predictive value (NPV) was 100%. There was an excellent agreement between the two methods as the Kappa value was 0.984. The difference in the two methods showed statistical significance. Based on our findings, the diagnostic performance of RDT was good. Hence, in the absence of good quality microscope and in emergency situation where quick diagnosis and treatment is required, RDT is an alternative and reliable method for diagnosis of malaria in Awka.