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Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age

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  • Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia

The diagnostic performance of histidine-rich protein 2 (HRP-2)–based malaria rapid diagnostic test (RDT) was evaluated in a mesoendemic area for malaria, Kaduna, Nigeria. We compared RDT results with expert microscopy results of blood samples from 295 febrile children under 5 years. Overall, 11.9% (35/295) tested positive with RDT compared with 10.5% (31/295) by microscopy: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100%, 98.5%, 88.6%, and 100%, respectively. The RDT sensitivity was not affected by transmission season, parasite density, and age. Specificity and positive PV decreased slightly during the high-transmission season (97.5% and 83.3%). The RDT test positivity rates in the low- and high-transmission seasons were 9.4% and 13.5%, respectively. Overall, the test performance of this RDT was satisfactory. The findings of a low proportion of RDT false positives, no invalid and no false-negative results should validate the performance of RDTs in this context.

Author Notes

* Address correspondence to Olufemi Ajumobi, Nigeria Field Epidemiology and Laboratory Training Programme, 50 Haile Selassie Street, Abuja, Nigeria. E-mail: femiajumobi@gmail.com

Authors' addresses: Olufemi Ajumobi, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, and National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria, E-mail: femiajumobi@gmail.com. Kabir Sabitu and Jacob Kwaga, Ahmadu Bello University, Zaria, Nigeria, E-mails: kssabitu@yahoo.com and jacobkwaga@yahoo.com. Patrick Nguku and Gabriele Poggensee, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, E-mails: drnguku@yahoo.com and gapo.nigeria@gmail.com. Godwin Ntadom, National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria, E-mail: ntadomg@yahoo.com. Sheba Gitta, African Field Epidemiology Network, Kampala, Uganda, E-mail: sgitta@afenet.net. Rutebemberwa Elizeus, Makerere University Kampala, Uganda, E-mail: ellie@musph.ac.ug. Wellington Oyibo, College of Medicine, University of Lagos, Nigeria, E-mail: wellao@yahoo.com. Peter Nsubuga, Global Health Solutions, Atlanta, GA, E-mail: pnsubuga@globalphsolutions.com. Mark Maire, Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Center for Disease Control and Prevention, Atlanta, GA, E-mail: vlq8@cdc.gov.

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