title: Malaria rapid diagnostic test evaluation at private retail pharmacies in Kumasi, Ghana.
abstract: OBJECTIVE
  Malaria rapid diagnostic test (MRDT) provides a good alternative to malaria microscopy diagnosis, particularly in resource-constrained settings. This study therefore evaluated MRDT in private retail pharmacies (PRPs) as a critical step in community case malaria management.
  
  
  METHODS
  In a prospective, cross-over, validation survey at six PRPs in the Ashanti Region of Ghana, 1200 patients presenting with fever in the preceding 48 h were sampled. Fingerstick blood samples were collected for preparation of thick and thin blood films for malaria microscopy. Categorized patients (600 each) went through the processes of MRDT or presumptive diagnosis (PD) of malaria. The malaria disease prevalence of the study area was established. Selectivity (Se), specificity (Sp), positive predictive value (PPV) along with false discovery rate (FDR), and negative predictive value (NPV) along with the false omission rate (FOR), and diagnostic odds ratio (DOR) of MRDT were then calculated.
  
  
  RESULTS
  While 43.0% tested positive using the MRDT, 57.0% tested negative. However, 62.0% MRDT-negative patients in addition to all the MRDT positives were given artemether-lumefantrine. Of those diagnosed by PD, 98.2% were prescribed with an antimalarial (microscopy however confirmed only 70.3% as positive). Se and Sp of the MRDT were 90.68 ± 11.18% and 98.68 ± 1.19%, respectively. Malaria prevalence was estimated to be 43.3%. PPV was 98.0%, FDR was 2.0%, NPV was 98.0%, FOR was 2.0%, and DOR was 2366.43.
  
  
  CONCLUSIONS
  Results highlighted good performance of MRDTs at PRPs which could inform decision toward its implementation.
authors: Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Kama Health Service, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: Rauf
authors: R
authors: Audu
authors: Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: Berko Panyin
authors: BP
authors: Anto
authors: Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: George Asumeng
authors: GA
authors: Koffuor
authors: Department of Pharmaceutical Sciences, Kumasi Polytechnic, Kumasi, Ghana.
authors: Akua Afriyie
authors: AA
authors: Abruquah
authors: Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors: Kwame Ohene
authors: KO
authors: Buabeng
keywords: Diagnostic odds ratio; Malaria; fingerstick blood samples; positive predictive value