Evaluation of Diagnostic Performance of Immunochromatographic Rapid Card Test for Malarial Antigen against Peripheral Smear Microscopy: A Cross-sectional Study

Background: Malaria poses a major public health problem in India and has emerged as a biggest health burden in terms of morbidity and mortality. Rapid detection of malarial parasite can ensure the prompt timely and efficient management of clinical cases and control of the disease. In India Peripheral smear microscopy still exists as the most commonly employed method for diagnosing malaria.

Objectives: To evaluate the diagnostic performance of Immunochromatographic Rapid Card Test (ICT) for malarial antigen against Peripheral smear microscopy for diagnosing Malaria.

Materials and Methods: This Cross sectional study was conducted in Dept. of Microbiology of a Rural tertiary care teaching hospital of Western Uttar Pradesh from January 2016 to August 2016.

Eight Hundred thirty seven patients with clinical suspicion of malaria whose samples were sent on advice by clinicians to the Microbiology laboratory for the peripheral smear microscopy and Rapid card test for malarial antigen were included in this study after obtaining clearance from Institutional Ethics committee.

Results: Out of the 837 blood samples tested ,106 (12.66%) samples tested positive for malaria by Peripheral smear microscopy and 109(13%) by ICT Rapid card tests. The sensitivity of ICT for non-falciparum malaria came out to be 82.65% lower than that for falciparum malaria(87.5%). The specificity of ICT for non. falciparum malaria(98.9%) was almost same as for falciparum malaria (99.3%).The accuracy of ICT for falciparum malaria(99.16%) was slightly higher than for non-falciparum malaria(97%).

Conclusion: This study suggests that ICT Rapid card test can not replace PS microscopy completely, but can be used as a complementary tool to microscopy, particularly in resource constrained remote rural areas of India.