DOI: 10.4103/njcp.njcp_67_26 ISSN: 1119-3077
The Fate of the Urine Malaria Test in Malaria Diagnosis: Evaluating its Diagnostic Accuracy in Plasmodium Falciparum Detection in Febrile Children in a Low-resource Country
I Nwangwa, OM Izuka, IF Ogbonna, IE Kalu
Background:
Malaria remains a significant threat to children, resulting in significant mortality in low-resource countries, including Nigeria. Among its causes,
Plasmodium falciparum
is the most prevalent and virulent, and the gold standard for its detection is Blood Smear Microscopy (BSM). However, BSM has some limitations, including its invasive blood sampling, need for expertise, and interobserver variability. The Urine Malaria Test (UMT), an easy-to-use, rapid, and non-invasive diagnostic technique, may address these limitations.
Aim:
To evaluate the diagnostic accuracy of UMT in detecting
Plasmodium falciparum
in febrile children and compare the findings with those of BSM, the gold standard.
Methods:
This hospital-based, cross-sectional comparative study recruited 264 febrile children aged 6–59 months from the Emergency Paediatric Unit, Federal Medical Centre, Umuahia.
Plasmodium falciparum
prevalence was determined using UMT and was compared with that of BSM. Additionally, the sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of UMT relative to BSM were determined.
Results:
P falciparum
prevalence using UMT and BSM was 43.2% and 38.6%, respectively, and was statistically similar (
P
= 0.29). There was a substantial agreement between these techniques (κ = 0.67). The sensitivity, specificity, PPV, and NPV of UMT in detecting
P falciparum
were 85.3%, 83.3%, 76.3%, and 90.0%, respectively.
Conclusion:
The UMT is comparable and substantially agrees with BSM, the gold standard, demonstrating high diagnostic accuracy in detecting
P. falciparum
malaria in febrile children. Thus, it is a suitable alternative to BSM, particularly in low-resource settings.