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ABSTRACT
Malaria remains a deadly parasitic disease that is common in tropical regions and affects approximately 4 billion people. According to the World Health Organization (WHO), malaria recorded 247 million cases, with 619,000 mortalities globally in 2021. Over 90% of the global disease burden occurs in sub-Saharan Africa (SSA). Light microscopy remains the gold standard of diagnosis, but malaria rapid diagnostic tests (RDTs) have become the primary diagnostic tool because they are easy to use and do not require much expertise. This cross-sectional study compared the diagnostic performance of two WHO-prequalified and two WHO-non-prequalified test kits to microscopy. The research question was whether the test kits met the minimum sensitivity and specificity of 95 % and 90 % established by the World Health Organization (WHO). Thick blood films from 300 febrile subjects were air-dried, stained with 10% Giemsa stain, and observed under the microscope for malaria parasite identification. The WHO prequalified First Response and Parahit test kits recorded 42% and 40% sensitivities. Also, Beacon and Oscar, WHO non-prequalified, recorded 42% and 38%. All the test kits recorded specificities above 90%. Microscopy recorded a malaria prevalence of 16.7% compared to an average of 6.7% for the test kit. The study highlighted the challenges of malaria control and elimination posed by sub-standard test kits used in endemic regions.
Key words: Rapid diagnostic tests, HRP-2, Lactate Dehydrogenase; Geimsa Stain: Light Microscopy