Malaria Rapid Diagnostic Test Effectiveness In Pregnant Women Attending First Antenatal Checkups At A State Hospital In Southwest Nigeria

Abstract

Background: The effects of pregnancy-related malaria on the mother, foetus, and infant continue to be a general health concern. Timely diagnosis and treatment of confirmed malaria infections can facilitate malaria case management in pregnancy. Malaria microscopy takes time and is influenced by several factors. Malaria rapid diagnostic tests (mRDTs) enable parasitological diagnosis and can aid precise and prompt diagnosis in pregnancy.

Methods: A cross-sectional study was conducted at State Hospital Iwo Osun State, Nigeria, between April and August 2017. Pregnant women visiting antenatal care for initial appointment during their current pregnancy were enrolled. Questionnaire that captured socio demographic data such as age, educational level, occupation and marital status were administered. Blood smears were prepared and RDT test was done for each participant. Slides were viewed under microscope to detect, count and different malaria parasite species. RDT outcomes were categorized as either positive or negative.

Results: Two hundred and eighty-four (284) pregnant women with age range of 15 to 46 years old were enrolled. Out of the occupation documented, farming was more, 74 (26.1%). More than half of the pregnant women enrolled, 167 (58.8%) had completed secondary school education. Many of the pregnant women were in their first trimester at enrolment, 271 (95.4%). Of the enrolled pregnant women, 53 (18.7%) of them were positive for malaria microscopy, while 55 (19.4%) were RDT positive. RDT proficiency showed sensitivity and specificity of 94.34% and 97.84%, respectively, with positive predictive values (PPV) of 90.93% and negative predictive value (NPV) of 98.69%. The results of microscopy and RDT results in this study in relation to gestational age was not significant.

Conclusion: The performance of RDT in this study showed it can be a supplementary diagnosis for malaria examination and thereby reduce laborious process in malaria microscopy, particularly for pregnant women attending ANC. Malaria screening using RDT in every ANC can enhance proper case management of malaria in pregnant women.