A Comparative Study of Diagnostic Methods of Malaria - Microscopy Versus Rapid Diagnostic Test Kits in a Tertiary Care Hospital, Rajasthan

Abstract

Saumya Singh1, Neelam Chauhan2, Jyoti Tomar3, Aditya Pratap Singh4

BACKGROUND
Malaria is one of the most prevalent parasitic diseases in the world including India.
Majority of malarial cases are found in countries where cost-effectiveness,
diagnostic test performance ease, and trained personnel, are the most important
considerations. We wanted to compare the two methods of rapid diagnostic tests
(RDTs) and microscopy in the diagnosis of malaria parasite infection.
METHODS
We studied 2,723 blood samples of patients who presented with signs and
symptoms of malaria from out patient department (OPD) and various wards of
Pacific Institute of Medical Science, Udaipur, Rajasthan, from Oct 2018 to Oct
2019. All samples obtained were first tested by RDTs and then the same samples
were used to make peripheral blood film (PBF) for microscopy.
RESULTS
During the 1-year period, rapid card test method showed 178 positives for malarial
parasite. Of these, 64 cases were positive for P. vivax and 108 cases for P.
falciparum. Peripheral blood smear method showed 160 cases positive for malarial
parasite. Of these, 55 cases were positive for P. vivax and 99 cases for P.
falciparum and 6 cases of co-infection. PBF failed to detect 9 cases of P. vivax and
9 cases of P. falciparum which were positive by rapid card test. So, 18 cases
reported PBF negative. Among these patients, there were 83 females and 95
males. Most affected age group was 16 – 30 years followed by 31 – 45 years.
Maximum samples were from the month of October 19 with a positivity rate 35.4
%.
CONCLUSIONS
RDTs based on malaria antigen (whole blood) method is as specific and more
sensitive than microscopy (which is being considered as the gold standard
method). Peripheral blood smear method still remains superior for accurate
species differentiation, quantitation of parasite and maintaining a permanent
record.
 

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