Comparative Malaria Diagnosis Between Microscopy and Rapid Diagnostic Tests Among Pregnant Women Attending Ahmad Sani Yariman Bakura Specialist Hospital in North-Western, Nigeria

Abstract

Background: Malaria remains a major public health problem in Nigeria, particularly among pregnant women, where it contributes significantly to maternal and fetal morbidity and mortality. Accurate and timely diagnosis is essential for effective treatment and control of the disease.

Aim: This study compared the diagnostic performance of microscopy and rapid diagnostic tests (RDTs) among pregnant women attending ANC at YBSH Gusau, Zamfara State, Nigeria.

Materials and Methods: A hospital-based cross-sectional study was conducted among 250 pregnant women. Venous blood samples were collected and examined using microscopy and two malaria rapid diagnostic tests kits (SD Bioline and Akray). Microscopy served as the gold standard for evaluating the performance of the rapid diagnostic tests. Data were analyzed using descriptive statistics, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the rapid diagnostic tests were determined.

Results: Microscopy detected malaria parasites in 40 (16.0%) participants, while SD Bioline detected 20 (8.0%) positive cases and Akray detected 16 (6.4%) positive cases. Evaluation of the RDTs against microscopy showed that SD Bioline had a sensitivity of 50.0%, specificity of 90.5%, positive predictive value of 50.0%, and negative predictive value of 90.5%. Akray demonstrated a sensitivity of 32.5%, specificity of 87.1%, positive predictive value of 32.5%, and negative predictive value of 87.1%. These findings indicate that SD Bioline performed better than the Akray RDT, although both kits showed lower sensitivity than microscopy.

Conclusion: The study concludes that microscopy remains the most reliable method for malaria diagnosis among pregnant women. However, SD Bioline rapid diagnostic tests may be used as a useful alternative in settings where microscopy is unavailable, while negative rapid diagnostic tests results in clinically suspected cases should be confirmed by microscopic examination.