Comparative Study between Slide Microscopy and Urine Test in the Diagnosis of Plasmodium falciparum among AMSH Patients, Ekiti State, Nigeria

Abstract

Malaria is a common disease in the sub-Saharan region of Africa, including Nigeria. It is a dangerous illness caused by the parasite,  Plasmodium. This study aimed to determine the efficiency of urine tests compared to slide microscopy using the Giemsa stain in the  diagnosis of malaria among students of Afe Babalola University Ado-Ekiti (ABUAD) who attended a multi-system hospital. This study aimed to determine simpler methods for easy detection of malaria parasites using urine samples and to compare the efficiency and  efficacy of the method with the slide microscopy Giemsa stain among patients of Afe Babalola University AdoEkiti (ABUAD) attending a  multi-system hospital. The study involved collecting 200 blood and urine samples from both admitted and outpatient students attending the ABUAD Multisystem Hospital (AMSH). Blood samples were analysed in the laboratory using Giemsa stain, whereas urine samples  were analysed using urine malaria test kits, which contain immunochromatographic materials impregnated with monoclonal antibodies  against Plasmodium species to detect elevated levels of Histidine Rich Protein-2 (HRP-2). Of the 200 patients diagnosed, blood microscopy  revealed that 47 (23.5%) had parasite loads of 1+ and 2+, while 67 (33.5%) and 25 (12.5%) had parasite loads of 3+ and 4+,  respectively, and 18 (9%) were negative. The results of blood microscopy showed that more than 90% of the samples were positive for  different malaria parasite loads, especially the 3 + category, whereas urine malaria tests (UMT) revealed that only 55% of the samples  studied were positive for Plasmodium falciparum. Moderate agreement between the UMT kit and blood smear microscopy was  demonstrated using a receiver operating characteristic (ROC). This study suggests that despite the drawbacks of microscopy, it is still the  Gold Standard for the detection of P. falciparum and should be used as frequently as feasible in the fight against this deadly disease.  However, the urine test kit can be adopted as a method of diagnosing malaria.