A Comparison of the Rapid Diagnostic Test and Microscopy for Malaria Diagnosis in Children Under five in Abia State, Nigeria

Children under five years bear the largest burden of malaria in Nigeria, and accurate diagnoses are important in malaria control and eventual eradication efforts. However, some reports on the accuracy of the most common malaria tests – microscopy and rapid diagnostic tests (RDTs) – are presently not satisfactory. Thus, the aim of this study is to determine the accuracy of malaria RDTs using microscopy as a gold standard, among children in Abia State, Nigeria.Between June 2015 and June 2018, blood samples were collected from 1,209 children in house to house surveys and tested for malaria using RDT and microscopy in Abia State. These data were used to assess the discriminatory accuracy of the RDT against the microscopy as a gold standard by analysis of its sensitivity and specificity. The predictive accuracy of the RDT was assessed by the positive predictive value (PPV) and negative predictive value (NPV) of the RDT against the microscopy at ρ=0.05.There was a statistically significant agreement between the results of the RDT and microscopy (ρ=0.001). The prevalence of childhood malaria by RDT and microscopy were 58.5% and 46.5% respectively. And the sensitivity, specificity, PPV and NPV of RDT were 79.36%, 56.26%, 63.08% and 72.51% respectively. This study concludes that there is need for accurate and reliable malaria diagnostic methods to be on track for achieving Sustainable Development Goal 3, and recommends thatcommunity diagnoses of childhood malaria should be combined with more specific diagnoses to improve the overall child health in Abia State, Nigeria.