A Comparative Study of Standard Peripheral Blood Smear and Antigen Detection Test in Diagnosis of Malaria in a Tertiary Care Hospital in Jalandhar

Abstract

Background: Malaria can cause fatal complications if the diagnosis and treatment are delayed. So, quick detection and early
treatment of malaria are the best policies for the management of disease. Microscopy has been the gold standard for malaria
diagnosis for decades. Recently, many new rapid diagnostic tests (RDTs) are being widely used. We have made an attempt
to compare peripheral smear and rapid antigen detection methods for the diagnosis of malaria. Material and methods: A
total of 500 blood samples were collected from patients presenting with symptoms of malaria. Thin and thick blood smears
were prepared and stained with Leishman’s stain. Plasmodium falciparum (Pf) HRP-2 antigen and Plasmodium vivax (Pv)
specific pLDH detection was done using rapid test device for malaria diagnosis. Results: Out of the 500 blood samples
tested, only 3.4% were positive for malaria. Difference between the positivity for Plasmodium species by both methods was
0.6%. Sensitivity, specificity, positive predictive value and negative predictive values were 85%, 99.6%, 89.5% and 99.4%,
respectively with peripheral blood film (PBF) method. Conclusion: The study highlights that the RDT, for diagnosis of
malaria, is as reliable as microscopy. Microscopy is simple, economical, sensitive and specific but it is time consuming and
requires a microscope. In places where such facilities are not available, rapid, simple and easy to interpret antigen detection
test can be done.