title: Assessment of Clinical Diagnosis, Microscopy, Rapid Diagnostic Tests, and Polymerase Chain Reaction in the Diagnosis of Plasmodium falciparum in Nigeria.
abstract: This study compares the performance of clinical diagnosis and three laboratory diagnostic methods (thick film microscopy (TFM), rapid diagnostic test (RDT), and polymerase chain reaction (PCR)) for the diagnosis of Plasmodium falciparum in Nigeria. Using clinical criteria, 217 children were recruited into the study out of which 106 (48.8%) were positive by TFM, 84 (38.7%) by RDT, and 125 (57.6%) by PCR. Using a composite reference method generated from the three diagnostic methods, 71 (32.7%) patients were found to be truly infected and 90 (41.5%) truly uninfected, while 56 (25.8%) were misidentified as infected or noninfected. When each of the 3 diagnostic methods was compared with the composite reference, PCR had sensitivity of 97.3%, specificity of 62.5%, positive predictive value (PPV) of 56.8%, and negative predictive value (NPV) of 97.8%; microscopy had sensitivity of 77.2%, specificity of 72%, PPV of 66.9%, and NPV of 81.1%, while RDT had sensitivity of 62.3%, specificity of 87.4%, PPV of 67.7%, and NPV of 84.5%. PCR test performed best among the three methods followed by TFM and RDT in that order. The result of this study shows that clinical diagnosis cannot be relied upon for accurate diagnosis of P. falciparum in endemic areas.
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Olusola
authors.initials: O
authors.lastname: Ojurongbe
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Olunike Olayeni
authors.initials: OO
authors.lastname: Adegbosin
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Sunday Samuel
authors.initials: SS
authors.lastname: Taiwo
authors.affiliation: Department of Biomedical Science, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Nigeria.
authors.forename: Oyebode Armstrong Terry
authors.initials: OA
authors.lastname: Alli
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Olugbenga Adekunle
authors.initials: OA
authors.lastname: Olowe
authors.affiliation: Department of Mathematical and Physical Sciences, Osun State University, PMB 4494, Osogbo, Nigeria.
authors.forename: Taiwo Adetola
authors.initials: TA
authors.lastname: Ojurongbe
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Oloyede Samuel
authors.initials: OS
authors.lastname: Bolaji
authors.affiliation: Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria.
authors.forename: Oluwaseyi Adegboyega
authors.initials: OA
authors.lastname: Adeyeba