Comparison of blood smear microscopy to a rapid diagnostic test for in-vitro testing for P. falciparum malaria in Kenyan school children.
OBJECTIVE
To compare the diagnostic performance of microscopy using Giemsa-stained thick and thin blood smears to a rapid malaria dipstick test (RDT) in detecting P. falciparum malaria in Kenyan school children.


METHODS
Randomised, controlled feeding intervention trial from 1998-2001.


METHODS
Rural Embu district, Kenya. The area is considered endemic for malaria, with four rainy seasons per year. Chloroquine resistance was estimated in 80% of patients. Children had a spleen rate of 45%.


METHODS
A sample of 515 rural Kenyan primary school children, aged 7-11 years, who were enrolled in a feeding intervention trial from 1998-2001.


METHODS
Percent positive and negative P. falciparum malaria status, sensitivity, specificity and positive and negative predictive values of RDT.


RESULTS
For both years, the RDT yielded positive results of 30% in children compared to microscopy (17%). With microscopy as the "gold standard", RDT yielded a sensitivity of 81.3% in 1998 and 79.3% in 2000. Specificity was 81.6% in 1998 and 78.3% in 2000. Positive predictive value was 47.3% in 1998 and 42.6% in 2000, and negative predictive value was 95.6% in 1998 and 94.9% in 2000.


CONCLUSIONS
Rapid diagnostic testing is a valuable tool for diagnosis and can shorten the interval for starting treatment, particularly where microscopy may not be feasible due to resource and distance limitations.
Neumann
C G
CG
Department of Paediatrics, School of Public Health, University of California, Los Angeles, CA 90095-1772, USA.
Bwibo
N O
NO
Siekmann
J H
JH
McLean
E D
ED
Browdy
B
B
Drorbaugh
N
N
D000818:Animals; D002648:Child; D005260:Female; D006801:Humans; D007630:Kenya; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008297:Male; D008853:Microscopy; D010963:Plasmodium falciparum / Q000648:ultrastructure; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012424:Rural Population; D012680:Sensitivity and Specificity
D011933:Reagent Kits, Diagnostic