title: Malaria rapid diagnostic test in children: The Zamfara, Nigeria experience.
abstract: BACKGROUND
  Malaria remains a major cause of under-five morbidity and mortality in Nigeria, and prompt diagnosis occupies a strategic position in its management. Malaria rapid diagnostic test (RDT), a nontechnical, easy to perform test promises to meet this need. It is important to locally document the usefulness of the use of RDT in making prompt malaria diagnosis in children.
  
  
  OBJECTIVE
  To determine the prevalence of malaria and evaluate the diagnostic performance of malaria RDT kit in febrile under-five children presenting to a Tertiary Health Facility in Gusau, North-Western Nigeria.
  
  
  METHODS
  A cross-sectional study of children aged 6-59 months, evaluated for malaria in a tertiary health facility from August 2012 to January 2013. Information was obtained from care providers of all subjects with fever and a presumptive diagnosis of malaria. All subjects were investigated using Giemsa stain microscopy and Carestart™ malaria RDT.
  
  
  RESULTS
  The prevalence of malaria in 250 febrile under-five children was 54%. Three-quarter (79%) of the children received inappropriate nonrecommended antimalaria prior to their presentation, including 20% who received chloroquine. The overall sensitivity of RDT was 40.3%. The specificity, positive and negative predictive values were 89.6%, 81.8%, and 56.5%, respectively.
  
  
  CONCLUSIONS
  Use of RDT should be encouraged for screening and diagnosis using a protocol such that febrile children with positive RDT results are confirmed as having malaria while those with negative results are further evaluated using microscopy.
authors.affiliation: Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
authors.forename: Isa
authors.initials: I
authors.lastname: Abdulkadir
authors.affiliation: Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
authors.forename: Hafsah Ahmad
authors.initials: HA
authors.lastname: Rufai
authors.affiliation: Federal Medical Centre, Gusau, Zamfara State, Nigeria.
authors.forename: Sunday Onazi
authors.initials: SO
authors.lastname: Ochapa
authors.affiliation: Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
authors.forename: Mado Sani
authors.initials: MS
authors.lastname: Malam
authors.affiliation: Federal Medical Centre, Gusau, Zamfara State, Nigeria.
authors.forename: Bilkisu Ilah
authors.initials: BI
authors.lastname: Garba
authors.affiliation: Federal Medical Centre, Gusau, Zamfara State, Nigeria.
authors.forename: Adebayo Ganiyu Yusuf
authors.initials: AG
authors.lastname: Oloko
authors.affiliation: Federal Medical Centre, Gusau, Zamfara State, Nigeria.
authors.forename: Idemudia Itoya
authors.initials: II
authors.lastname: George
keywords: Malaria; parasite density; prevalence; rapid diagnostic test; sensitivity; specificity