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

SummaryBackgroundThe 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.MethodsThe 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.ResultsThe 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).ConclusionMalaria 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.