Comparative study on the performance of microscopic and rapid diagnostic test (RDT) for malaria among some patients in Maiduguri metropolis

Malaria remains a major public health problem in Nigeria, that a positive, accurate and reliable microscopy or RDT should preferably be obtained before commencing treatment. High specificity will reduce unnecessary treatment with antimalarial drugs and improve the diagnosis. This study analyze the performance of microscopy and Rapid Diagnostic Techniques (RDT) used in the diagnosis of malaria at the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria from September to October, 2019. A total of 118 blood samples was screened for malaria by preparation of thick and thin film, Leishman staining and microscopic examination of the slides under oil immersion objectives. Rapid Diagnostic test (RDT) was performed using NADAL® Malaria 4 species test cassettes, with emphasis on falciparum malaria. The results shows that 65 patients (55.1%) were positive for malaria, out of which 42 (64.6%) were males, mainly (24.6%) within the young age group (1-10 years). Some of the patients 17 (26.2%) have started taking antimalarial drugs before coming to the hospital. Out of the 96 patients presented with acute malaria, only 43 (66.2%) were positive, but all those with severe cases (33.8%) were positive by both microscopic and RDT tests. In general, 53 patients (81.5%) were positive by microscopy, while only 12(18.5%) are RDT-positive. The study revealed a low performance of RDT with high number of false negative tests compared to microscopy on the same samples. It is therefore, necessary to reinforce training in microscopy, improved supplies and ensure proper handling/storage of the rapid test kits in malaria-endemic area, like Nigeria.