title: Reliability of rapid diagnostic tests in diagnosing pregnancy and infant-associated malaria in Nigeria.
abstract: BACKGROUND
  The effective management of maternal and infant malaria requires rational and prompt diagnosis. This study aims to determine the diagnostic efficiency of malaria RDT in infants and pregnant women.
  
  
  METHODS
  The study was conducted on infants (n=200), pregnant women (n=80) and non-pregnant women (n=100) who were recruited from two hospitals in Lagos, Nigeria. Plasmodium falciparum infections were assessed in the febrile subjects by microscopic examinations of blood smears and by RDT.
  
  
  RESULTS
  The lowest (44.3%) and the highest (83.3%) sensitivity (SS) values were recorded in the infants and pregnant women, respectively. Other diagnostic parameters, including the specificity (SP, 97.5%), positive predictive value (PPV, 92.1%) and negative predictive value (NPV, 72.8%), in the infants were greater than the values recorded in non-pregnant (SP=77.5%, PPV=83.9%, NPV=70.5%) and pregnant women populations (SP=65.6%, PPV=78.4%, NPV=72.4%). The diagnostic efficiency of malaria RDT exhibited higher sensitivity in women in early gestational stages (1st trimester=78.6% and 2nd trimester=88.0%) compared with those in the 3rd trimester (71.4%). The sensitivity of malaria RDT (100.0%) was significantly higher in the multigravid women than in the primigravida (78.6%) and secundigravida women (77.8%, P<0.05). The sensitivity of the RDT significantly increased with the intensity of the malarial parasites (P<0.05).
  
  
  CONCLUSIONS
  Malaria is endemic in the study populations. Malaria RDT can serve as a first-line of diagnosis for pregnant women in early gestational stages and multigravid women and can aid the differential diagnoses of other diseases due to its high specificity in infants.
authors.affiliation: Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria. Electronic address: zootund@yahoo.com.
authors.forename: Oyetunde T
authors.initials: OT
authors.lastname: Oyeyemi
authors.affiliation: Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria.
authors.forename: Oluwarotimi J
authors.initials: OJ
authors.lastname: Sode
authors.affiliation: Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria.
authors.forename: Olalekan D
authors.initials: OD
authors.lastname: Adebayo
authors.affiliation: Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria.
authors.forename: Grace O
authors.initials: GO
authors.lastname: Mensah-Agyei
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D002846:Chromatography, Affinity / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008297:Male; D008853:Microscopy / Q000379:methods; D009549:Nigeria; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011258:Pregnancy Tests / Q000379:methods*; D012680:Sensitivity and Specificity; D013997:Time Factors; D055815:Young Adult
keywords: Infants; Malaria RDT; Nigeria; Pregnant women