Abstract:
Background: Microscopy is the gold standard method currently
acceptable in diagnosis of malaria in a clinical setting but is subject to
diagnostic bias as it cannot detect malaria parasites as they are very low or
absent in peripheral circulation. Rapid immunochromatographic test (ICT) can
detect the parasite antigen in peripheraral circulation and thus may be a
suitable complementary epidemiological tool for malaria diagnosis among the
expectant women in low parasitaemia areas. However, the sensitivity and
accuracy of rapid ICT in diagnosis of malaria in pregnancy has not been
established. Methods: A laboratory based cross sectional study was used.
Blood samples from 314 pregnant women attending the antenatal clinic were
screened for malaria parasites using microscopy, rapid ICT and polymerase
chain reaction (PCR). Results: Out of the 314 samples analyzed for malaria,
44 samples (14.0%) were positive for P. falciparum by microscopy while 62
(19.7%) were positive by rapid ICT. The sensitivity and specificity of rapid
ICT was 84.4% and 96.8% respectively while that of microscopy was 68.8%
and 100.0% respectively. There was a moderate level of agreement between
results of rapid ICT and microscopy and high level of agreement when rapid
ICT results were compared against microscopy and PCR results (κ = 0.517; p
<0.001 and κ = 0.821;p <0.001) respectively. Conclusion:The findings of this
study suggest the potential adoption of rapid ICT as a complementary
epidemiology tool for malaria diagnosis among expectant women in areas of
low parasitaemia and where microscopy is difficult to implement.
