Performance of malaria rapid diagnostic tests as part of routine malaria case management in Kenya.
Data on malaria rapid diagnostic test (RDT) performance under routine program conditions are limited. We assessed the attributes of RDTs performed by study and health facility (HF) staffs as part of routine malaria case management of patients > or = 5 years of age in Kenya. Expert microscopy was used as our gold standard. A total of 1,827 patients were enrolled; 191 (11.6%) were parasitemic by expert microscopy. Sensitivity and specificity of RDTs performed by study staff were 86.6% (95% confidence interval [CI]: 79.8-93.5%) and 95.4% (95% CI: 93.9-96.9%), respectively. Among tests performed by HF staff, RDTs were 91.7% (95% CI: 80.8-100.0%) sensitive and 96.7% (95% CI: 92.8-100.0%) specific, whereas microscopy was 52.5% (95% CI: 33.2-71.9%) sensitive and 77.0% (95% CI: 67.9-86.2%) specific. Our findings suggest that RDTs perform better than microscopy under routine conditions. Further efforts are needed to maintain this high RDT performance over time.
de Oliveira
Alexandre Macedo
AM
Malaria Branch, Division of Parasitic Diseases, National Center for Vector-Borne, Zoonotic, and Enteric Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. acq7@cdc.gov
Skarbinski
Jacek
J
Ouma
Peter O
PO
Kariuki
Simon
S
Barnwell
John W
JW
Otieno
Kephas
K
Onyona
Phillip
P
Causer
Louise M
LM
Laserson
Kayla F
KF
Akhwale
Willis S
WS
Slutsker
Laurence
L
Hamel
Mary
M
D000962:Antimalarials / Q000627:therapeutic use; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000627:therapeutic use; D019090:Case Management; D004338:Drug Combinations; D004983:Ethanolamines / Q000627:therapeutic use; D005449:Fluorenes / Q000627:therapeutic use; D006268:Health Facilities; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D018512:Parasitemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes