On the discriminatory and predictive accuracy of the RDT against the microscopy in the diagnosis of malaria among under-five children in Nigeria

Malaria Journal
Adeniyi Francis Fagbamigbe

Abstract

Accurate identification of malaria cases is crucial to the management of cases and the eventual success of malaria eradication agenda. This study is designed to evaluate the discriminatory and predictive accuracy of malaria rapid diagnostic tests (RDTs) in Nigeria. The data obtained during the 2015 Nigeria Malaria Indicator Survey was used to quantify the discriminatory accuracy of the RDT against the microscopy through the analysis of its sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratio. The positive (PPV) and negative (NPV) predictive values, area under the receiver operating characteristic curve, and diagnostic odds ratio were used to assess the predictive accuracy of the RDTs using expert microscopy as a gold standard at p = 0.05. The McNemar paired test and the Kappa statistics were used to assess the level of agreement between the diagnostic tests. There was a significant but not an excellent agreement between the results of the RDT and microscopy tests (p < 0.001). The overall sensitivity of the RDT was 87.6% (85.9-89.2%), specificity was 75.8% (74.4-77.1%), while the diagnostic accuracy stood at 79.0% (77.9-80.0%). The LR+, LR-, PPV and NPV were 3.6 (3.4-3.8) and 0.16 (0.14-0.19), 57.5% (56.1...Continue Reading

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