Performance of the Novel Partec Rapid Malaria Test® in the Diagnosis of Malaria in a Rural Endemic Area; a Quicker, Cheaper and Cost Effective Alternative?
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Date
2010-07-12
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Abstract
Malaria remains the single largest cause of death in Africa killing one child in every 30 seconds but treatment decisions are often made based on clinical diagnosis since laboratory techniques to confirm the clinical suspicion are labour-intensive and costly. This study evaluated the recently developed Partec Rapid Malaria Test® (PM) for the detection of Plasmodium spp. in human blood from patients in an endemic area and compared the results with thick blood film Giemsa stain (GS), Binax NOW® rapid diagnostic test (BN RDT) and Real time PCR in terms of their performance and operational characteristics using an expanded reference as the gold standard. A total of seven hundred and fifty one (751) participants were involved in this study. Out of this 400(53.2%) were males and 351(46.7%) were females. Their ages ranged from 3 to 16 years with the modal age being 4 years (150/752).Using an expanded reference standard the sensitivities of GS, PM, Real time PCR and BN RDT were 96.7%, 97.3%, 97.3% and 96.5% respectively. The specificities were 100%, 98.5%, 64.6% and 96.7% respectively. The Positive Predictive Values (PPV) for GS, PM, Real time PCR and BN RDT were 100%, 97.7%, 62.8% and 95.6% respectively whilst the Negative Predictive Values (NPV) were 97.8%, 98.2%, 97.5% and 97.3% respectively. There was a strong agreement between three tests methods and the reference standard: k=0.97, 0.96 and 0.93 respectively for GS, PM and BN RDT but not with Real time PCR (k=0.56). Compared to each other, the tests methods had a strong agreement as well: GS vs PM, k= 0.96 and for PM vs BN RDT, k=0.87. Real time PCR had a higher positive detection rate compared to the other methods; 110/488 (22.5%) and 109/488 (22.3%) of the total samples were positive for Real time PCR but not GS and PM respectively. Parasite counts obtained from the PM were relatively lower than that obtained from the GS but the PM had better operational characteristics than the GS. The PM may therefore be used as an alternative method for Giemsa thick film staining but for parasite speciation, the Giemsa thin film remains preferable.
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A Thesis Submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in Partial Fulfillment of the Requirements for the Degree of MASTER OF PHILOSOPHY,