Performance of Microscopy Method and Rapid Diagnostic Tests in Malaria Diagnosis amongst Pregnant Women in Lagos, Southwest Nigeria

Malaria infection in pregnancy is a major public health problem which poses serious life threats to pregnant mothers and foetuses. Accurate diagnosis and prompt treatment of pregnancy associated malaria (PAM) are important in preventing adverse pregnancy outcomes. This study compared the diagnostic performance of two rapid diagnostic tests (RDTs), parasite lactate dehydrogenase (PLDH) based Optimal IT and parasite aldolase base Dr. Grey’s with the gold standard microscopy in pregnant women. Blood samples of 113 pregnant women were collected from two hospitals in Lagos and screened for malaria parasite by Giemsa stained smear and two malaria rapid diagnostic tests, Optimal IT parasite lactate dehydrogenase and Dr. Grey aldolase. The results showed that, out of 113 blood samples screened, 23 (20.4%), 51 (45.1%) and 14 (12.4%) were positive by microscopy, Aldolase and PLDH respectively. 17 (33.3%) and 34 (66.7%) of the aldolase positive samples were positive and negative by microscopy respectively. 11 (21.6%) of the aldolase positive samples were positive for both microscopy and PLDH. Of the positive samples, 34 (66.7%) were negative for both microscopy and PLDH. 3 (13.0%) were positive by microscopy but negative by aldolase and PLDH (RDTs). There was no statistically significant difference between the performances of the different RDTs. This study revealed that microscopy, the gold standard underestimated the real burden of malaria during pregnancy and aldolase (RDT) performed better than microscopy and PLDH, the other RDT in diagnosing pregnant-associated malaria.