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Diagnostic Performance of Malaria Rapid Diagnostic Test and Microscopy Compared with PCR for Detection of Plasmodium falciparum Infections among Primary Schoolchildren in Kibiti District, Eastern Tanzania: An Area with Moderate Malaria Transmission

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  • 1 Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
  • | 2 Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden;
  • | 3 Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden;
  • | 4 Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
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A substantial decline of malaria transmission intensity has been observed in sub-Saharan Africa over the past two decades and may affect the diagnostic performance of malaria rapid diagnostic test (mRDT) and microscopy. Diagnostic performance of histidine-rich protein II (HRP-II)/pan-lactate dehydrogenase (pLDH)–based mRDT and microscopy was evaluated against polymerase chain reaction (PCR) for the diagnosis of Plasmodium falciparum infection among 316 primary schoolchildren in Kibiti district, in 2016. Polymerase chain reaction detected more cases of P. falciparum infection than mRDT or microscopy. Using PCR as reference, the sensitivity and specificity of mRDT were 75.9% (95% CI = 62.8–86.1) and 96.9% (95% CI = 94.0–98.7), respectively, whereas that of microscopy were 63.8% (95% CI = 50.1–76.0) and 95.7% (95% CI = 92.5–97.9), respectively. Polymerase chain reaction and other molecular methods should be considered for use in schools and other epidemiological surveys as supplement to mRDT or microscopy.

Author Notes

Address correspondence to Billy Ngasala, Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65011, Dar es Salaam, Tanzania. E-mail: bngasala70@yahoo.co.uk

Financial support: This work was supported by SIDA, through the Muhimbili University of Health and Allied Sciences and Karolinska Institute bilateral malaria project 2015/20.

Authors’ addresses: Billy Ngasala and Doreen D. Mutemi, Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, E-mails: bngasala70@yahoo.co.uk and dodayvid4@hotmail.com. Richard O. Mwaiswelo, Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania, E-mail: richiemwai@yahoo.com.

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