Performance of rapid immunochromatographic test and microscopy in determination of malaria prevalence among expectant women in Kericho county hospitals, kenya
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Date
2014
Authors
Njeru, Annastasia Wangari
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Malaria, a parasitic infection transmitted by mosquitoes, is one of the most devastating
infectious diseases and contributes very significantly to maternal and foetal mortality.
Microscopic analysis has been the standard diagnostic technique for identifying malaria
infections for more than a century but is unable to detect all infections as parasites can be
sequestered in the placenta. Good quality microscopy is also lacking in many resourcelimited
settings, as it requires well-trained, competent personnel, infrastructure as well as
effective quality control and assurance. It is also labour-intensive and time-consuming,
sensitivity decreases as the density of malarial parasites in the blood decreases. The
problems associated with implementing and sustaining a high level of skilled microscopy
appropriate for clinical diagnosis, particularly in the field setting, have prompted the
development of a variety of technologically simple malaria rapid diagnostic tests. Rapid
immunochromatographic test may provide a solution as emerging evidence suggests that
they are capable of detecting Plasmodiumfalciparum which sequesters in the intervillous
space of the placenta better than microscopy. The proposed study aims at evaluating the
performance of the rapid immunochromatographic strip test and microscopy in
determination of malaria prevalence during pregnancy using polymerase chain reaction as
a confirmatory test. The study targets the primary health care setting using Kericho
District Hospital, Kipsitet and Fort Ternan Health Centres which represent resourcelimited
setting, reliant on microscopy as malaria diagnostic test. They lack well-trained,
competent personnel, infrastructure as well as effective quality control and quality
assurance to make accurate diagnosis. Participants will be drawn from a population of
pregnant women aged 18 years and above, who have malaria symptoms and are not on
antimalarial drugs attending antenatal care visits. Using microscopy as the gold standard,
Polymerase Chain Reaction as a confirmatory test, the sensitivity, specificity, negative
predictive value and positive predictive value of the IC test will be determined. The
prevalence of malaria among expectant mothers will also be determined using
microscopy and rapid ICTs. Data analysis will be done using SPSS version 17.
McNemar's Chi square statistic will be used to test the level of agreement between the
two tests. The findings of this study will be crucial in determining the suitability and
reliability of rapid immunochromatographic test that will allow community health care
workers to make rapid and accurate diagnosis of malaria in expectant mothers and make
immediate therapeutic decisions