Reliability of rapid diagnostic tests in diagnosing pregnancy and infant-associated malaria in Nigeria

Abstract

Summary: Background: The effective management of maternal and infant malaria requires rational and prompt diagnosis. This study aims to determine the diagnostic efficiency of malaria RDT in infants and pregnant women. Methods: The study was conducted on infants (n = 200), pregnant women (n = 80) and non-pregnant women (n = 100) who were recruited from two hospitals in Lagos, Nigeria. Plasmodium falciparum infections were assessed in the febrile subjects by microscopic examinations of blood smears and by RDT. Results: The lowest (44.3%) and the highest (83.3%) sensitivity (SS) values were recorded in the infants and pregnant women, respectively. Other diagnostic parameters, including the specificity (SP, 97.5%), positive predictive value (PPV, 92.1%) and negative predictive value (NPV, 72.8%), in the infants were greater than the values recorded in non-pregnant (SP = 77.5%, PPV = 83.9%, NPV = 70.5%) and pregnant women populations (SP = 65.6%, PPV = 78.4%, NPV = 72.4%). The diagnostic efficiency of malaria RDT exhibited higher sensitivity in women in early gestational stages (1st trimester = 78.6% and 2nd trimester = 88.0%) compared with those in the 3rd trimester (71.4%). The sensitivity of malaria RDT (100.0%) was significantly higher in the multigravid women than in the primigravida (78.6%) and secundigravida women (77.8%, P < 0.05). The sensitivity of the RDT significantly increased with the intensity of the malarial parasites (P < 0.05). Conclusion: Malaria is endemic in the study populations. Malaria RDT can serve as a first-line of diagnosis for pregnant women in early gestational stages and multigravid women and can aid the differential diagnoses of other diseases due to its high specificity in infants. Keywords: Malaria RDT, Infants, Pregnant women, Nigeria