Evaluation of Immunochromatographic Rapid Diagnostic Test versus Peripheral Blood Smear for Diagnosis of Malaria in Nepal

Abstract

Malaria is one of the most important parasitic diseases of humans. It is the major vector disease with
occasional focal outbreaks in Nepal. Annually more than 60,000 clinical cases of malaria occur out of that
about 10,000 cases are confirmed cases of which about 1200 happen to be plasmodium falciparum cases.
Several factors predispose to transmission of deadly / resistant strains to local population which in turn
leads to cerebral malaria having both high mortality and morbidity. As it is well known that peripheral blood
smear remains the “gold-standard” in diagnostic measure apart from compatible history but circumstances
and situations like in periphery of developing country like ours we can not overlook the advantage of
Rapid Diagnostic Tests (RDTs) like OptiMAL test which detects parasitic lactate dehydrogenase in a
drop of patient’s blood. This study showed that the malaria detected by OptiMAL have sensitivity 96%
and specificity of 100% amongst 50 cases of malaria, the OptiMAL is able to detect 48 positive cases.
Despite the cost of the test, it’s sensitivity and specificity are two remarkable factors in diagnosing the
disease rapidly even in case of slide/smear negative ones. The utility of RDTs are not enough studied
in our part of world especially in our country where even sufficient trained manpower is always a rarity.
The importance of this test emphasize the easy-to-use tool for early diagnosis and prompt institution of
appropriate therapy to reduce both mortality, morbidity and in return reducing hospital stay and increasing
working hour of productive manpower.

DOI:  10.3126/mjsbh.v9i1.3483

Medical Journal of Shree Birendra Hospital Vol.9(1) 2010 9-13