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Updated: Jul 13, 2026
A Multi-detection Assay for Malaria Transmitting Mosquitoes
Published on: February 28, 2015
Uncomplicated malaria in children: The place of rapid diagnostic test
Hassan Abdullahi Elechi1, Adamu Ibrahim Rabasa2, Muhammad Faruk Bashir2
1Department of Paediatrics, University of Maiduguri, Maiduguri, Nigeria.
Insights
Malaria rapid diagnostic tests (MRDTs) show poor sensitivity in Nigerian children under five. These histidine-rich protein-2 based tests are unreliable for diagnosing malaria in this vulnerable population.
Area of Science:
- Pediatric infectious diseases
- Diagnostic test evaluation
- Public health in developing nations
Background:
- Malaria significantly impacts Nigerian children under five, causing high morbidity and mortality.
- Accurate malaria diagnosis is crucial for effective control and preventing antimalarial drug misuse.
- Malaria rapid diagnostic tests (MRDTs) aim to improve diagnosis but show inadequate performance in young children.
Purpose of the Study:
- To evaluate the diagnostic performance of histidine-rich protein-2 based MRDTs in Nigerian children under five.
- To assess the reliability of MRDTs for diagnosing acute uncomplicated malaria in this age group.
Main Methods:
- A cross-sectional study enrolled 433 febrile outpatients aged under five.
- Malaria parasitemia was assessed using ACON MRDT and microscopy (thick and thin blood films).
Main Results:
- MRDT demonstrated low sensitivity (8.3%) but high specificity (100%), PPV (100%), and NPV (74%).
- MRDT sensitivity significantly increased with patient age (P = 0.007) and parasite density (P < 0.001).
Conclusions:
- Histidine-rich protein-2 based MRDTs are unreliable for diagnosing malaria in Nigerian children under five.
- The study highlights the inadequacy of current MRDTs for this vulnerable pediatric population.
Background:
Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate.
Materials And Methods:
In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate.
Result:
Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001).
Conclusion:
Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria.
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