ASSESSMENT OF MALARIA RAPID DIAGNOSTIC TEST AND UTILISATION OF LABORATORY SERVICES FOR MALARIA DIAGNOSIS AT MAKARFI GENERAL HOSPITAL, KADUNA STATE

ASSESSMENT OF MALARIA RAPID DIAGNOSTIC TEST AND UTILISATION OF LABORATORY SERVICES FOR MALARIA DIAGNOSIS AT MAKARFI GENERAL HOSPITAL, KADUNA STATE

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ABSTRACT

In Nigeria, malaria accounts for 30% mortality in children <5years (U5). World Health

Organisation guidelines recommend parasite-based diagnosis prior to commencement of

antimalarial treatment. However, empirical treatment remains a common phenomenon at homes

and in clinical settings because of presumed high malaria prevalence. This is compounded by

inadequate information on accuracy of malaria rapid diagnostic test (RDT). Data on factors

affecting the utilisation of malaria laboratory services (MLS) is not readily available. We

conducted a study to assess the diagnostic accuracy of Standard Diagnostic (SD) Bioline malaria

rapid diagnostic test, and to determine the factors affecting the utilisation of MLS in febrile

children in Kaduna State, Northern Nigeria.

We conducted a cross-sectional study of 296 caregivers of febrile U5 at Makarfi General

Hospital (MGH), Kaduna state from December 2010 to August 2011. We used structured

questionnaires to collect data on socio-demographics of caregivers, clinical information on

febrile U5, and utilisation of MLS. Blood samples were collected from 296 U5 and examined for

malaria parasites with SD Bioline rapid diagnostic test (RDT) and routine microscopy. The

diagnostic accuracy of the RDT was determined. Focus group discussions (n=4) were conducted

at Makarfi communities to determine the factors affecting utilisation of MLS among caregivers

of children U5. Eight key informants were interviewed to determine the capacity for malaria

diagnosis at MGH.

VI


The sensitivity, specificity, negative and positive predictive values of SD Bioline RDT were

100%, 98.5%, 100% and 88.6% respectively. The prevalence of malaria in the febrile children

was 10.5% and 11.8% by RDT and microscopy respectively. Plasmodium falciparum infection

rate was 100%. Overall, 3.7% of caregivers were offered any malaria laboratory test by health

staff and 5.5% have ever heard about MLS. Non-request of MLS by health staff, lack of

awareness, presumptive treatment, and long distance from health centre, caregiver’s perceived

severity of illness, high cost, and non-availability of MLS were responsible f


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