Diagnostic Accuracy of Malaria RDTs: Correlation with Microscopy in Akwa Ibom State, Nigeria

Background: Malaria is one of the leading causes of death in the tropics and sub-tropics. The study aimed at validating the performance of rapid diagnostic tests (RDTs) kits and using the microscopy as the standard. Methods: Blood samples were collected from 390 patients suspected of having malaria across five health facilities. Samples were tested with SD Bioline HRP-2 and CareStartTM pLDH/HRP-2 test kits, with microscopy as the gold standard. Data analysis was done using STATA version14 software, where descriptive statistics and chi-square test, were calculated, with p<0.05. Results: Overall malaria prevalence was 278 (71.3%) for microscopy, 239 (61.3%) for CareStartTM, 189 (48.5%) for SD Bioline HRP-2, and 134 (34.4%) for clinical methods. More males were infected than females with malaria parasites by clinical method 72 (39.8%) and CareStartTM 121 (66.9%). Age-related prevalence showed that 55.8% and 67.5% were positive for SD Bioline and CareStartTM, re-spectively. The sensitivity of pLDH/HRP-2 (67.4%) was higher than that of SD Bioline HRP-2 (57.6%), while the specificity of CareStartTM (58.9%) was lower than that of HRP-2 (74.1%). The pos-itive predictive value (PPV) of 84.7% was recorded for HRP-2 test, while negative predictive value (NPV) of 43.7% was recorded for CareStartTM test. Conclusion: CareStartTM possessed advantages over the SD Bioline HRP-2 RDT, such as improved positive predictive value, making it more effective in accurately diagnosing positive malaria cases. The study highlights the need for reliable diagnostic methods to improve malaria management and reduce its burden.