The role of malaria rapid diagnostic test on the management of malaria amongst children in Kisarawe district, Coast region

Abstract

Malaria is a disease caused by protozoa parasite of the genus Plasmodium and infection occurs, following bite of infected female Anopheline mosquito. Malaria diagnosis continues to be a major challenge in malaria control strategies in Sub-Sahara Countries including Tanzania. Giemsa staining technical is widely practiced but mis-diagnosis has coursed troubles. The objective of this study was to determine the role of malaria rapid diagnostic test (mRDT) in routine clinical practice for the management of malaria episode amongst children. Methodology This was a cross-sectional study involving children aged five years and below attending a health care facility due to fever. A convenient sampling method was used to enroll children and blood samples were collected for mRDT, and smear microscopy. Exit interview was done. The gathered data was analyzed using Epi info soft ware, version 3.5.1. Results Results revealed a Sensitivity of RDT of 86% and Specificity of 98% and Predictive Value Positive 97% when the gold standard is reader two. For parasite density the linear Coefficient Correlation of two readers was 0.86, hence the linear correlation coefficient = 0.92 which is within normal acceptable range. There was discordant in parasite prevalence of which reader two had 17.2%, and reader one had 13.8%, an indication of misdiagnosis of reader one. However, even though 66 (22.7%) of children were treated based on mRDT only 50 (17.2%) should have been treated so 16 (5.5%) of children were given ALU unnecessarily. Discussion Malaria rapid diagnostic test is simple to perform and we can rely on the test because of the sensitivity and specificity that it has in detecting the presence of malaria parasites in blood. The test detects the presence of parasite antigen (HRP-2) so the chances that diagnosis can fail are less. Conclusion From this study, we recommend the roll out of the mRDT especially to areas with poor infrastructure. We recommend investigation of all children with fever using RDT before treatment and whenever facility allows, all the positive cases to be confirmed with microscopy. However, in situation where microscopy is not possible, all RDT positive cases should receive treatment.