Malaria rapid diagnostic tests (RDTs) are non microscopic tests that
provide a rapid detection of malaria infections in infected
individuals. The objective of this study was to evaluate the
performance of ParaHit and OptiMAL tests for detection of malaria
infections as compared with routine microscopy. This facility-based
study was carried out in Mwanza, north-western Tanzania and involved
outpatients attending Igoma Health Centre. Blood samples were tested
for malaria infection using the two RDTs and compared with Giemsa
stained blood films examined using microscope. A total of 243
individuals (median age= 22 years) were involved in the study.
Microscopy had a higher detection rate of 19.7% (48/243) as compared to
ParaHit (4.5%) and OptiMAL (3.7%). Low sensitivity of 21.2% and 17%,
but high specificity of 99.4% for ParaHit and OptiMAL, respectively was
observed. Of all positive blood slides for Plasmodium falciparum ,
78.7% had low parasite density (80 -720 parasite/µl of blood).
These slides were negative for malaria parasite for both RDTs. Over 80%
of study participants who reported fever had negative blood slides for
malaria parasites by microscopy. On the other hand, 44.7% of those who
reported no fever had positive blood slides for P. falciparum. Study
participants who reported to have fever and high parasite density above
720 parasite/µl were likely to be positive by both RDTs (OR= 6.8;
P= 0.031529). In conclusion, the overall performance of both RDTs in
detecting asexual P. falciparum was low as compared to microscopy and
their performance were highly affected by parasite density. This calls
for further evaluation studies before RDTs are widely used in
peripheral health facilities in order to minimize potential severe
consequences