title: Uncomplicated malaria in children: The place of rapid diagnostic test.
abstract: BACKGROUND
  Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate.
  
  
  METHODS
  In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate.
  
  
  RESULTS
  Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001).
  
  
  CONCLUSIONS
  Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria.
authors.affiliation: Department of Paediatrics, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Hassan Abdullahi
authors.initials: HA
authors.lastname: Elechi
authors.affiliation: Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.
authors.forename: Adamu Ibrahim
authors.initials: AI
authors.lastname: Rabasa
authors.affiliation: Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.
authors.forename: Muhammad Faruk
authors.initials: MF
authors.lastname: Bashir
authors.affiliation: Department of Paediatrics, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Mustapha Modu
authors.initials: MM
authors.lastname: Gofama
authors.affiliation: Department of Paediatrics, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Halima Abubakar
authors.initials: HA
authors.lastname: Ibrahim
authors.affiliation: Deparetment of Medical Microbiology, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Umoru Muhammed
authors.initials: UM
authors.lastname: Askira
keywords: Febrile; malaria; malaria rapid diagnostic test; out-patient; under-five
references.citation: Am J Trop Med Hyg. 1996;55(1 Suppl):71-6
references.pmid: 8702041
references.citation: Nature. 2005 Mar 10;434(7030):214-7
references.pmid: 15759000
references.citation: J Infect Dis. 2008 Feb 15;197(4):510-8
references.pmid: 18240951
references.citation: BMJ. 2009 Jul 07;339:b2606
references.pmid: 19584113
references.citation: J Clin Microbiol. 2006 Aug;44(8):2773-8
references.pmid: 16891491
references.citation: Malar J. 2010 Jul 07;9:192
references.pmid: 20609211
references.citation: J Clin Microbiol. 1999 Apr;37(4):1233
references.pmid: 10215455
references.citation: J Clin Microbiol. 2002 Dec;40(12):4675-8
references.pmid: 12454171
references.citation: Indian Pediatr. 2001 Jun;38(6):650-4
references.pmid: 11418731
references.citation: Trop Med Int Health. 2003 Oct;8(10):876-83
references.pmid: 14516298
references.citation: Trans R Soc Trop Med Hyg. 1998 Sep-Oct;92(5):527-31
references.pmid: 9861370
references.citation: J Infect Dis. 2005 Sep 1;192(5):870-7
references.pmid: 16088837
references.citation: Clin Microbiol Rev. 2008 Jan;21(1):97-110
references.pmid: 18202438
references.citation: Trop Med Int Health. 2002 Jan;7(1):45-52
references.pmid: 11851954
references.citation: Niger Postgrad Med J. 2008 Jun;15(2):65-9
references.pmid: 18575475
references.citation: Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):1-11
references.pmid: 11425172
references.citation: Acta Trop. 2002 Apr;82(1):51-9
references.pmid: 11904103
references.citation: Ann Trop Med Parasitol. 1952 Sep;46(2):173-200
references.pmid: 12986705
references.citation: J Pak Med Assoc. 2000 Dec;50(12):401-5
references.pmid: 11191438
references.citation: Malar J. 2010 Jan 21;9:28
references.pmid: 20092620
references.citation: Am J Trop Med Hyg. 2007 Jun;76(6):1092-7
references.pmid: 17556616
references.citation: Malar J. 2010 Oct 26;9:294
references.pmid: 20974009
references.citation: Niger J Clin Pract. 2011 Apr-Jun;14(2):195-200
references.pmid: 21860139
references.citation: Trans R Soc Trop Med Hyg. 2008 Jan;102(1):25-31
references.pmid: 18031779
references.citation: Malar J. 2008 Oct 03;7:202
references.pmid: 18834523
references.citation: Interdiscip Perspect Infect Dis. 2009;2009:415953
references.pmid: 19547702