Comparison of Reliability of Rapid Diagonostic Test to Microscopy in the Diagnosis of Malaria at Gulu Regional Referral Hospital

  • P Kyambadde
  • H Acidiri
  • H Wabwire
  • D Okello
  • I Mbolwa
  • S Asio
  • I Byona
  • A Oriekot
  • W Kiganda
  • JK Kuule
  • EI Odongo-Aginya


Background: Malaria is one of the leading causes of mortality in sub-Saharan Africa and continues to be  a threat to life. Everyday 320 people die due to malaria in Uganda. Statistics from the ministry of health  show that of all outpatient visits at health Centres, malaria represents 25 - 40 % with 9 - 14 % in  in-patient. Microscopy remains the main stay for malaria diagnosis. Nevertheless it is slow and needs a  lot of experience and expertise, consequently there is need to use a faster method but retaining the  precision of the microscope.
Objective: To determine the reliability of the rapid diagnostic test in comparison to microscopy in the  diagnosis of malaria thereafter improve the management of malaria.
Design: An experimental study.
Setting: Gulu Regional Referral Hospital laboratories.
Subjects: The study was experimental; using 250 malarial suspected participants with fever .The malaria rapid diagnostic method and microscopy of the stained malarial slides were the methods used.
Results: Of the 250 samples, 214 were found to be negative using microscopy and 208 using Rapid  Diagnostic Test suggesting over suspicion of malaria. Microscopy had a sensitivity of 85.7%, specificity of 94.7% and Negative predictive value (NPV) of 97.2%.
Conclusion: RDTs can be used to quickly confirm the clinical diagnosis of malaria to reduce irrational use of anti-malarials when microscopy is not available before initiating treatment to avoid irrational use of drugs. However due to the cost, microscopy still remains the gold standard method for the diagnosis of Malaria.

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eISSN: 0012-835X