Factors Affecting the Validity of Pfhrp2-Based Rapid Diagnostic Test Kit in the Diagnosis of Malaria in Afikpo, Ebonyi State: A Pilot Study

Aim: To assess the factors affecting the validity of histidine-rich protein II (HRP2)-based rapid diagnostic test (RDT) kit for diagnosis of malaria in Afikpo North Local Government Area, Ebonyi State.

Study Design: Quantitative methods using both structured questionnaires and serological tests were employed to collect data on factors affecting the validity of HRP2-based RDT kit results for malaria diagnosis.

Place and Duration of Study Sample: Four different health facilities including Akanu Ibiam Federal Polytechnic Medical Centre, Unwana, between November 2022 and March 2023.

Methodology: We interviewed eleven (11) health workers (HWs) (5 males and six females) on factors affecting the validity of RDT kits. We also included 50 patients (19 males and 31 females; aged 1-40 years) with symptoms of malaria to validate some of the factors mentioned by the health workers. Replicates of CareStart® TM malaria RDT kits were used to test some of the factors on blood samples collected from the patients. Data collected was analyzed using the Chi-square test.

Results: The majority of the HWs use microscopy (54.5%) while 45.5% use RDT for the diagnosis of malaria. The majority of the HWs claimed that the quantity of buffer reagent (50%) and wait time (14.3%) affects the performance of RDT kits. However, there was no statistically significant difference (p>0.05) in the prevalence of malaria (36%) among the different buffer quantities and wait times tested. Hence, the tested buffer reagent volumes and wait times do not affect the performance of rapid diagnostic tests. It is important to validate these findings in future studies with a larger sample size.