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Comparative Evaluation of the Diagnostic Performance Characteristics of a One-Step Urine Malaria Test (UMT) against Rapid Diagnostic Tests (RDT) in Febrile Patients from Fako Division, Cameroon

Nforbugwe Achu Che Awah, Bihnwi Rengerline Nchotu, Agnes Djema Bongah, Nguedia Jules Clement Assob

Background: Presently, all malaria diagnostic methods like: Microscopy and Rapid Diagnostic Tests are invasive as they depend on blood samples for malaria diagnosis. Hence this study was aimed at comparing the diagnostic performance characteristics of the novel UMT to the currently used Blood RDT, and to find out the efficacy of this UMT in detecting low parasitemia in the study population.

Methodology: A cross sectional study involving 200 febrile participants, with no signs and symptoms of rheumatoid arthritis, kidney diseases, no history of hematuria, >15/µl leucocytes and urobilinogens of >1 mg/dl in their urine, were recruited from the month of April to August 2017 in the Limbe and Buea Regional Hospitals. The main samples requested for analyses were urine and blood.

Results: Using the blood smear microscopy as standard, out of the 200 participants, 93 (46.5%) was positive for Plasmodium malaria. UMT had a sensitivity and specificity of 82.41% and 83.48% while that of RDT was 84.09% and 83.03% respectively falciparum (CI: 72.80% to 92.05%, Kappa 0.665, p=0.001). The UMT had a lowest limit of detection of 140 parasites/μl which was similar to RDT. The PPV and NPV of UMT and RDT were (81.74% and 85.98%) and (80.04% and 87.28%), respectively. There was a close agreement between the RDT and UMT when compared to microscopy (83.5% and 83.0% respectively).

Conclusion: The UMT kit that was evaluated in comparison to the blood based RDT, showed a lot of similarities using the blood smear microscopy as gold standard. Hence, it can be used in our setting for the prompt and accurate diagnosis of malaria in febrile patients.