Assessment of the performance of the mRDT test in asymptomatic first trimester malaria infection in nulliparous pregnant women

Abstract

Background: Pregnancy poses specific challenges in the diagnosis of Plasmodium falciparum infection due to parasite sequestration in the placenta. The diagnosis of Plasmodium falciparum infection in pregnant mothers therefore requires highly sensitive methods in order  to detect the presence of parasites. These include those that detect the presence of antigens and those that detect and quantify the  presence of the malaria parasites.

Objective: The study assessed the performance of mRDT diagnostic test ((PfHRP2-RDT) in the detection of malaria infection in blood  samples from nulliparous pregnant women within the first trimester of pregnancy in Western Kenya.

Methods: This was a prospective study on blood specimens collected from pregnant women in a malaria-endemic region in Kenya. m-polymerase chain reaction (mPCR) and mRDT tests were performed. The diagnostic accuracy of m-RDT was compared with mPCR as  the gold standard for the purpose of this study.

Setting: Twelve primary health facilities in Busia, Bungoma and Kakamega Counties in  Kenya

Results: Out of 264 mPCR positive samples, 130 were mRDT positive (true positives) while 134 were mRDT negative (false  negative). And out of 441 mPCR negative samples, 41 were positive on mRDT (false positive). Thus, in comparison with mPCR, the  sensitivity and specificity of mRDT to detect malaria infection in nulliparous pregnant mothers in first trimester was 49.2% and 88.9%  respectively

Conclusions: The sensitivity of mRDT to detect Plasmodium falciparum infections in nulliparous pregnant mothers in the  first trimester was not satisfactory compared to mPCR tests.