ArticleMalaria journal2023
Accuracy of diagnosis among clinical malaria patients: comparing microscopy, RDT and a highly sensitive quantitative PCR looking at the implications for submicroscopic infections.
Article in Malaria journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 3 of them syntheses that pooled it.
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Who cites it
71 citing papers in PubMed, 3 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Prevalence and associated factors of microscopy-confirmed malaria among the general population in Ethiopia: a systematic review and meta-analysis.Malaria journal · 2026Pooled it
- Performance and challenges of malaria rapid diagnostic tests in endemic regions of Africa.Scientific reports · 2025Pooled it
- Performance of rapid diagnostic tests for malaria diagnosis in Nigeria: a systematic review and meta-analysis.Malaria journal · 2025Pooled it
- Low practical knowledge but high willingness to use malaria rapid diagnostic tests among healthcare workers in the Republic of Congo.BMC public health · 2026Article
- Translational opportunities in aptamer and nanobody lateral flow assays within the WHO REASSURED framework.Sensors & diagnostics · 2026Review
- Mechanistic insights into subclinicaliScience · 2026Review
- From silent infection to symptomatic malaria: host phenomic determinants of Plasmodium falciparum outcomes in Fanteakwa South District, Ghana.Malaria journal · 2026Article
- Serological surveillance for malaria elimination in Southeast Asia: a scoping review.Malaria journal · 2026Article
- Evaluation of microscopy and first response™ malaria Ag PAN/Pf RDT compared to qPCR and hemoglobin levels in pregnant women at delivery in Busia County, Western Kenya.BMC infectious diseases · 2026Article
- Diagnostic challenges in malaria detection: A comparative diagnostic performance of HRP2-based rapid diagnostic tests, microscopy, and PCR at Bichena primary hospital, Northwest Ethiopia.Parasite epidemiology and control · 2026Article
- Molecular surveillance of Falciparum malaria in Rwanda: Shifts in parasite prevalence and risk factors between the 2014-15 and 2019-20 Rwanda Demographics and Health Surveys.medRxiv : the preprint server for health sciences · 2026Article
- School-aged children as a silent reservoir of Plasmodium falciparum: findings from a cross-sectional survey conducted in Burkina Faso in 2022.Malaria journal · 2026Article
- Uncovering silent malaria reservoirs in Southern Ethiopia: community-based molecular detection of asymptomatic and sub-microscopic infections and their implications for diagnosis and control.Malaria journal · 2026Article
- Evaluation of malaria rapid diagnostic test kit performance in a high-transmission setting: a facility-based cross-sectional study in rural Ghana.Malaria journal · 2026Article
- Field and laboratory evaluation of Abbott-Bioline™ Malaria Ag Pf/Pv RDT performance in a high-transmission setting: contrasting results with a low-endemic area.Malaria journal · 2026Article
- Malaria misdiagnosis among febrile patients in Senegal: implications for the underestimation of Plasmodium species diversity and malaria burden.Malaria journal · 2026Article
- Post-transfusion Malaria in Morocco and Non-endemic African Countries: A Systematic Review of Reported Cases.Cureus · 2026Review
- Hemozoin as a Diagnostic Biomarker: A Scoping Review of Next-Generation Malaria Detection Technologies.Biosensors · 2026Review
- Molecular, Transcriptomic, and Proteomic Characterization ofmedRxiv : the preprint server for health sciences · 2026Article
- Automated microscopy for malaria diagnosis in a reference laboratory in nonendemic settings.Parasites & vectors · 2026Article
11 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe World Health Organization recommends parasitological confirmation of all suspected malaria cases by microscopy or rapid diagnostic tests (RDTs) before treatment. These conventional tools are widely used for point-of-care diagnosis in spite of their poor sensitivity at low parasite density. Previous studies in Ghana have compared microscopy and RDT using standard 18S rRNA PCR as reference with varying outcomes. However, how these conventional tools compare with ultrasensitive varATS qPCR has not been studied. This study, therefore, sought to investigate the clinical performance of microscopy and RDT assuming highly sensitive varATS qPCR as gold standard.
methods1040 suspected malaria patients were recruited from two primary health care centers in the Ashanti Region of Ghana and tested for malaria by microscopy, RDT, and varATS qPCR. The sensitivity, specificity, and predictive values were assessed using varATS qPCR as gold standard.
resultsParasite prevalence was 17.5%, 24.5%, and 42.1% by microscopy, RDT, and varATS qPCR respectively. Using varATS qPCR as the standard, RDT was more sensitive (55.7% vs 39.3%), equally specific (98.2% vs 98.3%), and reported higher positive (95.7% vs 94.5%) and negative predictive values (75.3% vs 69.0%) than microscopy. Consequently, RDT recorded better diagnostic agreement (kappa = 0.571) with varATS qPCR than microscopy (kappa = 0.409) for clinical detection of malaria.
conclusionsRDT outperformed microscopy for the diagnosis of Plasmodium falciparum malaria in the study. However, both tests missed over 40% of infections that were detected by varATS qPCR. Novel tools are needed to ensure prompt diagnosis of all clinical malaria cases.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.