Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities
Abstract Background Although microscopy is a standard diagnostic tool for malaria and the gold standard, it is infrequently used because of unavailability of laboratory facilities and the absence of skilled readers in poor resource settings. Malaria rapid diagnostic tests (RDT) are currently used in...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-05-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-018-2363-9 |
| _version_ | 1818542723407282176 |
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| author | Akili K. Kalinga Charles Mwanziva Sarah Chiduo Christopher Mswanya Deus I. Ishengoma Filbert Francis Lucky Temu Lucas Mahikwano Saidi Mgata George Amoo Lalaine Anova Eyako Wurrapa Nora Zwingerman Santiago Ferro Geeta Bhat Ian Fine Brian Vesely Norman Waters Mara Kreishman-Deitrick Mark Hickman Robert Paris Edwin Kamau Colin Ohrt Reginald A. Kavishe |
| author_facet | Akili K. Kalinga Charles Mwanziva Sarah Chiduo Christopher Mswanya Deus I. Ishengoma Filbert Francis Lucky Temu Lucas Mahikwano Saidi Mgata George Amoo Lalaine Anova Eyako Wurrapa Nora Zwingerman Santiago Ferro Geeta Bhat Ian Fine Brian Vesely Norman Waters Mara Kreishman-Deitrick Mark Hickman Robert Paris Edwin Kamau Colin Ohrt Reginald A. Kavishe |
| author_sort | Akili K. Kalinga |
| collection | DOAJ |
| description | Abstract Background Although microscopy is a standard diagnostic tool for malaria and the gold standard, it is infrequently used because of unavailability of laboratory facilities and the absence of skilled readers in poor resource settings. Malaria rapid diagnostic tests (RDT) are currently used instead of or as an adjunct to microscopy. However, at very low parasitaemia (usually < 100 asexual parasites/µl), the test line on malaria rapid diagnostic tests can be faint and consequently hard to visualize and this may potentially affect the interpretation of the test results. Fio Corporation (Canada), developed an automated RDT reader named Deki Reader™ for automatic analysis and interpretation of rapid diagnostic tests. This study aimed to compare visual assessment and automated Deki Reader evaluations to interpret malaria rapid diagnostic tests against microscopy. Unlike in the previous studies where expert laboratory technicians interpreted the test results visually and operated the device, in this study low cadre health care workers who have not attended any formal professional training in laboratory sciences were employed. Methods Finger prick blood from 1293 outpatients with fever was tested for malaria using RDT and Giemsa-stained microscopy for thick and thin blood smears. Blood samples for RDTs were processed according to manufacturers’ instructions automated in the Deki Reader. Results of malaria diagnoses were compared between visual and the automated devise reading of RDT and microscopy. Results The sensitivity of malaria rapid diagnostic test results interpreted by the Deki Reader was 94.1% and that of visual interpretation was 93.9%. The specificity of malaria rapid diagnostic test results was 71.8% and that of human interpretation was 72.0%. The positive predictive value of malaria RDT results by the Deki Reader and visual interpretation was 75.8 and 75.4%, respectively, while the negative predictive values were 92.8 and 92.4%, respectively. The accuracy of RDT as interpreted by DR and visually was 82.6 and 82.1%, respectively. Conclusion There was no significant difference in performance of RDTs interpreted by either automated DR or visually by unskilled health workers. However, despite the similarities in performance parameters, the device has proven useful because it provides stepwise guidance on processing RDT, data transfer and reporting. |
| first_indexed | 2024-12-11T22:25:52Z |
| format | Article |
| id | doaj.art-4504f1567eaa4f79b40e6f5bc366d585 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-11T22:25:52Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-4504f1567eaa4f79b40e6f5bc366d5852022-12-22T00:48:17ZengBMCMalaria Journal1475-28752018-05-0117111010.1186/s12936-018-2363-9Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilitiesAkili K. Kalinga0Charles Mwanziva1Sarah Chiduo2Christopher Mswanya3Deus I. Ishengoma4Filbert Francis5Lucky Temu6Lucas Mahikwano7Saidi Mgata8George Amoo9Lalaine Anova10Eyako Wurrapa11Nora Zwingerman12Santiago Ferro13Geeta Bhat14Ian Fine15Brian Vesely16Norman Waters17Mara Kreishman-Deitrick18Mark Hickman19Robert Paris20Edwin Kamau21Colin Ohrt22Reginald A. Kavishe23National Institute for Medical Research, Tukuyu CentreTanzania Peoples Defense ForcesHenry Jackson Foundation Medical Research InternationalTanzania Peoples Defense ForcesNational Institute for Medical Research, Tanga CentreNational Institute for Medical Research, Tanga CentreHenry Jackson Foundation Medical Research InternationalHenry Jackson Foundation Medical Research InternationalHenry Jackson Foundation Medical Research InternationalFORGYN Health Systems Consultants LLcWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchFio CorporationFio CorporationFio CorporationFio CorporationWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchWalter Reed Army Institute of ResearchKilimanjaro Christian Medical University CollegeAbstract Background Although microscopy is a standard diagnostic tool for malaria and the gold standard, it is infrequently used because of unavailability of laboratory facilities and the absence of skilled readers in poor resource settings. Malaria rapid diagnostic tests (RDT) are currently used instead of or as an adjunct to microscopy. However, at very low parasitaemia (usually < 100 asexual parasites/µl), the test line on malaria rapid diagnostic tests can be faint and consequently hard to visualize and this may potentially affect the interpretation of the test results. Fio Corporation (Canada), developed an automated RDT reader named Deki Reader™ for automatic analysis and interpretation of rapid diagnostic tests. This study aimed to compare visual assessment and automated Deki Reader evaluations to interpret malaria rapid diagnostic tests against microscopy. Unlike in the previous studies where expert laboratory technicians interpreted the test results visually and operated the device, in this study low cadre health care workers who have not attended any formal professional training in laboratory sciences were employed. Methods Finger prick blood from 1293 outpatients with fever was tested for malaria using RDT and Giemsa-stained microscopy for thick and thin blood smears. Blood samples for RDTs were processed according to manufacturers’ instructions automated in the Deki Reader. Results of malaria diagnoses were compared between visual and the automated devise reading of RDT and microscopy. Results The sensitivity of malaria rapid diagnostic test results interpreted by the Deki Reader was 94.1% and that of visual interpretation was 93.9%. The specificity of malaria rapid diagnostic test results was 71.8% and that of human interpretation was 72.0%. The positive predictive value of malaria RDT results by the Deki Reader and visual interpretation was 75.8 and 75.4%, respectively, while the negative predictive values were 92.8 and 92.4%, respectively. The accuracy of RDT as interpreted by DR and visually was 82.6 and 82.1%, respectively. Conclusion There was no significant difference in performance of RDTs interpreted by either automated DR or visually by unskilled health workers. However, despite the similarities in performance parameters, the device has proven useful because it provides stepwise guidance on processing RDT, data transfer and reporting.http://link.springer.com/article/10.1186/s12936-018-2363-9MalariaAutomatedDeki ReaderRDTInterpretation |
| spellingShingle | Akili K. Kalinga Charles Mwanziva Sarah Chiduo Christopher Mswanya Deus I. Ishengoma Filbert Francis Lucky Temu Lucas Mahikwano Saidi Mgata George Amoo Lalaine Anova Eyako Wurrapa Nora Zwingerman Santiago Ferro Geeta Bhat Ian Fine Brian Vesely Norman Waters Mara Kreishman-Deitrick Mark Hickman Robert Paris Edwin Kamau Colin Ohrt Reginald A. Kavishe Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities Malaria Journal Malaria Automated Deki Reader RDT Interpretation |
| title | Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities |
| title_full | Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities |
| title_fullStr | Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities |
| title_full_unstemmed | Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities |
| title_short | Comparison of visual and automated Deki Reader interpretation of malaria rapid diagnostic tests in rural Tanzanian military health facilities |
| title_sort | comparison of visual and automated deki reader interpretation of malaria rapid diagnostic tests in rural tanzanian military health facilities |
| topic | Malaria Automated Deki Reader RDT Interpretation |
| url | http://link.springer.com/article/10.1186/s12936-018-2363-9 |
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