Ayeh-Kumi P.F., Akalifa B.G., Nkrumah N.O., Asmah R.H., Dayie N.T.K.D.
Department of Microbiology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana; Navrongo Health Research Centre, P.O. Box 114, Navrongo, Ghana; Department of Microbiology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana; University of Ghana School of Allied Health Sciences, P.O. Box KB 143, Accra, Korle-Bu, Ghana
Ayeh-Kumi, P.F., Department of Microbiology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana; Akalifa, B.G., Navrongo Health Research Centre, P.O. Box 114, Navrongo, Ghana; Nkrumah, N.O., Department of Microbiology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana; Asmah, R.H., University of Ghana School of Allied Health Sciences, P.O. Box KB 143, Accra, Korle-Bu, Ghana; Dayie, N.T.K.D., Department of Microbiology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana
At peripheral health facility levels, the diagnosis of malaria is difficult due to lack of infrastructure. In the study reported here, the diagnostic performance of a batch of 'DiaMed OptiMAL-IT' (Cressier, Switzerland) rapid antigen tests were examined in parallel with routine microscopy for a select population of high risk individuals: 202 pregnant women and 200 children less than 5 years old in an endemic setting in Ghana. Results of both diagnostic methods were compared to that of cross-checking microscopy, taken as gold standard, at the Navrongo Health Research Centre. Of the 402 patients, 218 (54.2%) were confirmed with Plasmodium falciparum infections by cross-checking. All 218 patients (100%) were accurately diagnosed with malaria by routine microscopy. Of these, 151 (69.3%) were positive by DiaMed OptiMAL-IT test (26 false positives, 67 false negatives). DiaMed OptiMAL-IT had the following performance indicators for detection of P. falciparum among pregnant women and children less than 5 years respectively: Sensitivity-50.5% [95% CI (40.6-60.3)], 87.7% [95% CI (78.7-92.1)]; Specificity-82.5% [95% CI (73.1-89.1)], 89.6% [95% CI (80.8-94.8)]; Predictive values for positive tests-75.7% [95% CI (63.7-84.8)], 91.6% [95% CI(85.2-95.8%)]; Predictive values for negative tests-60.6% [95% CI (51.7-68.9)], 83.8% [95% CI (74.5-90.3)]; Likelihood ratio for positive tests-2.88, 10.8; Likelihood ratio for negative tests-0.59, 0.19; Cohens Kappa values-0.33 [95% CI (0.20-0.43), 0.76 [95% CI (0.65-0.83)]. Our results suggest that DiaMed OptiMAL-IT tests should not replace microscopy in our endemic setting. © 2011 Indian Society for Parasitology.
antimalarial agent; adult; article; child; controlled study; diagnostic procedure; endemic disease; female; Ghana; health care facility; high risk patient; human; laboratory diagnosis; major clinical study; malaria falciparum; malaria test; male; microscopy; nonhuman; Plasmodium falciparum; Plasmodium malariae; Plasmodium ovale; Plasmodium vivax; predictive value; pregnant woman; preschool child; priority journal; school child; screening test; sensitivity and specificity
