OBJECTIVES: Rapid diagnostic tests (RDTs) are promoted for the diagnosis of malaria in many countries. The question arises whether laboratories where the current method of diagnosis is microscopy should also switch to RDT. This problem was studied in Kassala, Sudan where the issue of switching to RDT is under discussion. METHODS: Two hundred and three blood samples were collected from febrile patients suspected of having malaria. These were subsequently analysed with microscopy, RDT (SD Bioline P.f/P.v) and PCR for the detection and identification of Plasmodium parasites. RESULTS: Malaria parasites were detected in 36 blood samples when examined microscopically, 54 (26.6%) samples were found positive for malaria parasites by RDT, and 44 samples were positive by PCR. Further analysis showed that the RDT used in our study resulted in a relatively high number of false positive samples. When microscopy was compared with PCR, an agreement of 96.1% and k = 0.88 (sensitivity 85.7% and specificity 100%) was found. However, when RDT was compared with PCR, an agreement of only 81.2 and k = 0.48 (sensitivity 69% and specificity 84%) was found. CONCLUSION: PCR has proven to be one of the most specific and sensitive diagnostic methods, particularly for malaria cases with low parasitaemia. However, this technique has limitations in its routine use under resource-limited conditions, such as our study location. At present, based on these results, microscopy remains the best option for routine diagnosis of malaria in Kassala, eastern Sudan.
OBJECTIVES: Rapid diagnostic tests (RDTs) are promoted for the diagnosis of malaria in many countries. The question arises whether laboratories where the current method of diagnosis is microscopy should also switch to RDT. This problem was studied in Kassala, Sudan where the issue of switching to RDT is under discussion. METHODS: Two hundred and three blood samples were collected from febrile patients suspected of having malaria. These were subsequently analysed with microscopy, RDT (SD Bioline P.f/P.v) and PCR for the detection and identification of Plasmodium parasites. RESULTS:Malaria parasites were detected in 36 blood samples when examined microscopically, 54 (26.6%) samples were found positive for malaria parasites by RDT, and 44 samples were positive by PCR. Further analysis showed that the RDT used in our study resulted in a relatively high number of false positive samples. When microscopy was compared with PCR, an agreement of 96.1% and k = 0.88 (sensitivity 85.7% and specificity 100%) was found. However, when RDT was compared with PCR, an agreement of only 81.2 and k = 0.48 (sensitivity 69% and specificity 84%) was found. CONCLUSION: PCR has proven to be one of the most specific and sensitive diagnostic methods, particularly for malaria cases with low parasitaemia. However, this technique has limitations in its routine use under resource-limited conditions, such as our study location. At present, based on these results, microscopy remains the best option for routine diagnosis of malaria in Kassala, eastern Sudan.
Authors: Serge Y Ongagna-Yhombi; Paul Corstjens; Eran Geva; William R Abrams; Cheryl A Barber; Daniel Malamud; Sungano Mharakurwa Journal: Malar J Date: 2013-02-22 Impact factor: 2.979
Authors: Awadalla H Kashif; Gamal K Adam; Ahmed A Mohmmed; Salah E Elzaki; Ahmed M AbdelHalim; Ishag Adam Journal: Diagn Pathol Date: 2013-04-15 Impact factor: 2.644
Authors: Tajeldin M Abdallah; Abdel Aziem A Ali; Mohammed Bakri; Gasim I Gasim; Imad R Musa; Ishag Adam Journal: Malar J Date: 2012-12-05 Impact factor: 2.979
Authors: Naomi W Lucchi; Mitra Poorak; Jenna Oberstaller; Jeremy DeBarry; Ganesh Srinivasamoorthy; Ira Goldman; Maniphet Xayavong; Alexandre J da Silva; David S Peterson; John W Barnwell; Jessica Kissinger; Venkatachalam Udhayakumar Journal: PLoS One Date: 2012-02-20 Impact factor: 3.240