Accuracy of Malaria Diagnosis by Microscopy Vs. Rapid Diagnostic Test in Tertiary Care Hospital Nawabshah

Background: The WHO recommends all suspected malaria cases to be confirmed by laboratory diagnosis (microscopy or rapid diagnostic test (RDT)), wherever possible, before the commencement of antimalarial treatment. Malaria diagnosis using microscopy is currently the gold standard. However, malaria rapid diagnostic tests (mRDTs) were developed to simplify the diagnosis in regions without access to functional microscopy. Objective: The determine the accuracy of malaria diagnosis by microscopy vs. rapid diagnostic test at Peoples University of Medical and Health Sciences Nawabshah. Study Design: It was a cross-sectional study. Setting: Peoples University of Medical & Health Sciences Diagnostic & Research Laboratory in Nawab shah was the site of this investigation. Duration: Duration of study was 6 months after the approval of synopsis from 02-01-2023 to 02-07-2023 Material And Methods: Blood samples were collected from the fingers of 370 patients who were suspected to have malaria. The diagnosis of malaria involved the utilisation of two microscopic detection methods microscopy and RDT that employ immunological chromatographic processes. Consecutive participants were tested using both microscopy and mRDT. The results were analysed using SPSS version 25. Results: The mean age of the participants was 31.75 years (SD = 2.76). In terms of gender, 175 participants (47.29%) were male, and 195 (52.70%) were female. Fever was reported by 278 (75%), headache was present in 255 (68.91%). Regarding vomiting, 108 (29.18%) experienced it. Microscopic examination detected malaria parasites in 187 cases (50.54%), while 183 cases (59.45%) tested negative for the presence of malaria. Out of the total cases, 208 individuals (56.21%) tested positive for malaria using the RDT, while 162 cases (43.78%) yielded negative results. RDT exhibited a sensitivity of 90.24%, while Microscopy had a sensitivity of 81.81%. RDT demonstrated a specificity of 86.06%, while Microscopy had a specificity of 70.43%. The overall accuracy of RDT was 79.73%, and Microscopy had an accuracy of 65.67%. RDT showed a disease prevalence of 56.76%, while Microscopy had a prevalence of 49.59%. RDT had a PPV of 88.94%, while Microscopy had a PPV of 73.91%. RDT had an NPV of 87.65%, while Microscopy had an NPV of 79.13%. Conclusion: Our study concludes that Rapid Diagnostic Tests (RDTs) outperform microscopy in diagnosing malaria, offering higher sensitivity, specificity, and accuracy. This underscores the importance of integrating RDTs into malaria diagnostic protocols and continuous research to address methodological limitations. Implementing RDTs can facilitate early treatment interventions, ultimately benefiting public health by reducing transmission and mortality rates.