Diagnosis of malaria: A comparison between microscopy and rapid diagnostic test among under-five children at Gusau, Nigeria

Background: Malaria remains a disease of public health concern in tropical countries. Diagnosis in such countries largely depends on clinical assessment, microscopy (as the gold standard) and recently by rapid diagnostic tests (RDTs). This study was conducted to document common presenting symptoms of malaria, compare microscopy and RDT in the diagnosis of malaria in children in Gusau, Nigeria. Materials and Methods: A cross-sectional, study of children under-five years with presumptive diagnosis of malaria that was managed at the pediatric outpatient department and emergency pediatric unit of Yariman Bakura Specialist Hospital, Gusau. All consecutive children that met the inclusion criteria were recruited over a 4 weeks period. Malaria thick film microscopy and RDTs were carried out on all children. Results: Of the 118 children enrolled, 61 (51.69%) were males while 57 (48.31%) were females. Fever and vomiting were the most common presenting complaints. Microscopy was positive in 55 (46.61%) while RDT was positive in 10 (8.47%) of the children. Only 5 (4.24%) were positive for both microscopy and RDT. Fifty-eight (49.15%) children had negative microscopy and RDT results. There was no significance when positivity of both tests were compared ( χ 2 = 0.050, P = 0.822). RDT had a sensitivity of 9.09%, a specificity of 92.06%, positive predictive value of 50.00%, and a negative predictive value of 53.70%. Conclusion: Our study observed higher positivity rate for microscopy than RDT. We recommend microscopy to be carried out on all patients suspected of having malaria where possible, even in the presence of negative RDT.