Page 108 - Invited Paper Session (IPS) - Volume 2

IPS186 Fagbamigbe, A. F.
unwarranted stress, anxiety etc. Eusebi et al have already advocated for strict
evaluation of the diagnostic accuracy of testing procedure aimed at validating
any potential diagnostic tool [18]. This study is, therefore, designed to provide
the malaria programmers with situation assessment of the accuracy of RDTs
being used in Nigeria and to also determine the distribution of the levels of
accuracy in terms of discrimination and prediction. It was hypothesized in this
study that the outcomes of both the RDT and microscopy malaria tests are not
in agreement. The findings in this study will improve programme
implementation and enhance the much-needed progress towards malaria
control and eradication in Nigeria.

2. Methods
Malaria testing using RDT
Using the same blood sample collected for anaemia testing, a drop of
blood was tested immediately with the SD BIOLINE Malaria Ag P.f (HRP-II)™
(Standard Diagnostics, Inc.) RDT, being a qualitative test “to detect histidine-
rich protein II antigen of Plasmodium falciparum (Pf) in human whole blood”
[4]. The test procedures were handled by well-trained field laboratory
scientists in accordance with the RDTs’ manufacturer’s instructions. The RDT
results were provided to each child’s parent or guardian in oral and written
forms within 15 minutes and were recorded on the Biomarker Questionnaire.
Children that tested positive to malaria and not currently on treatment with
artemisinin-based combination therapy (ACT) or who had not completed a full
course of the ACT during the preceding 2 weeks were given full treatment
according to the Nigeria national malaria treatment guidelines[4].
Malaria testing using blood smears
In addition to the RDT, thick and thin blood smears were prepared in the
field. Each blood smear slide was labelled according to guidelines and
transmitted to the laboratory. The thick and thin smear slides were stained at
zonal staining and taken to the ANDI Centre of Excellence for Malaria
Diagnosis, University of Lagos, Nigeria for logging and microscopic reading.
Other details of the testing procedures have been reported earlier[4].
Description of variables
The outcome variable in this study is the result of the RDT and microscopy
malaria tests while the independent factors considered are child’s household
wealth quintiles, child age, and sex of children, mother’s educational
attainment, place of residence, region, sleeping under a long-lasting
insecticide-treated net or any ever treated nets recently, experience of fever
within 2 weeks preceding the survey, and the level of anaemia as used in earlier
studies[3,20]. The ages of the children were categorized into 0-6, 7-23, and
24-59 months as used in earlier studies on under-five children [21,22].

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