Low sensitivity but high specificity of ParaHIT-f in diagnosing malaria among children attending outpatient department in Butimba District Hospital, Mwanza, Tanzania

Malaria is the leading cause of mortality among under-fives in the sub-Saharan Africa. The gold standard method for the diagnosis of malaria is by the use of microscopy which is time consuming and requires skilled technicians. Recently the cost effective antigen based rapid diagnostic tests (RDTs) such as ParaHIT-f have been introduced in various places for the diagnosis of malaria. The choice of these RDTs to use in a certain country and specific geographical locations is critical to malaria diagnosis, treatment and ultimately control of drug resistance. This study was conducted to evaluate the sensitivity and specificity of the cheapest and easily available RDT in the study area, using microscopy as gold standard. This cross-sectional study was conducted to determine the performance of ParaHIT-f in diagnosing malaria in 300 children attending outpatient department at Butimba district hospital. Two thick and one thin blood smear were stained using standard Giemsa stain. The prevalence of P. falciparum Malaria was 5.7% and 15.7% by ParaHIT-f and microscopy respectively; the difference was significant (p< 0.001). The sensitivity and specificity of ParaHIT-f were 29.8% and 98.8% respectively. There was a strong association between parasitaemia of ≥1000parasites/µl and being positive for ParaHIT-f diagnostic test (P < 0.001). There is a need to revisit the use of ParaHIT-f in Tanzania. Further studies on the sensitivity and specificity are needed. A good quality control system on the performance of ParaHIT-f and other RDTs is highly recommended.