1. Concordance analysis of three diagnostic tests for malaria in the symptomatic population of Colombian endemic municipalities
- Author
-
Cortés LJ and Guerra ÁP
- Subjects
- Cities, Colombia epidemiology, Comorbidity, DNA, Protozoan genetics, Humans, Malaria, Falciparum blood, Malaria, Falciparum epidemiology, Malaria, Falciparum parasitology, Malaria, Vivax blood, Malaria, Vivax epidemiology, Malaria, Vivax parasitology, Parasitemia blood, Parasitemia epidemiology, Plasmodium falciparum genetics, Plasmodium falciparum isolation & purification, Plasmodium vivax genetics, Plasmodium vivax isolation & purification, Reproducibility of Results, Sensitivity and Specificity, Symptom Assessment, Chromatography, Affinity, Endemic Diseases, Malaria, Falciparum diagnosis, Malaria, Vivax diagnosis, Parasitemia diagnosis, Polymerase Chain Reaction
- Abstract
Introduction: Taking into account the difficulty of performing malaria microscopic diagnosis in rural areas, rapid diagnostic tests (RDT) are a good alternative, but it is important to verify their diagnostic performance. Objective: To evaluate the diagnostic performance of the RDTs used in five Colombian departments by comparing them with the microscopic diagnosis and using PCR as the reference standard. Materials and methods: Thick blood film and RDTs were used to diagnose symptomatic individuals; additionally, the filter paper was impregnated with blood for the molecular test. Results: We included 314 samples whose percentage of positivity for malaria was 49% by PCR, 48% by microscopy and 46% by RDT; parasitemia ranged between 180 and 23,800 p/μL of blood. The concordance of the results from the microscopy units and those of the PCR (National Laboratory of Reference) was as follows: Cohen’s kappa coefficient, 0.975 (95% CI: 0.950-0.999); sensitivity, 97% (95% CI 95-100); specificity 100% (95% CI: 100-100), and kappa index of species, 0.958 (IC95%: 0.912-1.00). The concordance between the Pf/Pv RDT (at the microscopy units) and the PCR (National Laboratory of Reference) was as follows: kappa coefficient, 0.878 (95% CI: 0.784-0.973); sensitivity, 94% (95% CI: 87-100); specificity, 95% (95% CI: 90-100), and kappa index of species, 1.0 (95% CI: 1.00-1.00). The concordance between the Pf/Pan RDT versus PCR was: Cohen’s kappa coefficient, 0.920 (95 % CI: 0.865- 0.974); sensitivity, 94% (95% CI: 90-98); specificity, 99% (95% CI 95-100), and kappa index of species, 0.750 (IC95% 0,637-0,863). Conclusion: The results of this study support the use of RDTs in Colombia; however, more training of the personnel is required to accurately differentiate Plasmodium species.
- Published
- 2020
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