Malaria Immunosurveillance And Evaluation Of Rapid Diagnosis Test In Meru South Sub County, Tharaka-Nithi County, Kenya

ABSTRACT

Despite intensive worldwide attempt to control malaria, it remains one of the most fatal and widespread protozoan infection of mankind. About 2.4 billon people inhabit malaria prone regions which is about forty percentage of the world population. Prompt accurate, diagnosis and treatment is important to avert suffering of malaria patients. Malaria infection is a serious global challenge in the affected countries. The rapid diagnosis tests of malaria are recent diagnostic techniques whose performance has not been evaluated in many malaria endemic regions like Tharaka-Nithi County. The main purpose of this study was to perform malaria immunosurveillance and evaluate performance of rapid diagnosis test for malaria in Meru South Sub County, Tharaka-Nithi County. The study design was hospital based cross-sectional study in the laboratory at Chuka Level 5 Hospital. Three hundred and eighty four blood specimens were used from febrile patients with clinical manifestation of malaria infection. The blood specimens were used for thin, thick smear for microscopy and rapid diagnosis test. The results were analyzed by t-test to compare the two microscopy and Rapid diagnostic methods. A p-value > 0.05 was obtained meaning there is no difference in performance between the Rapid Diagnostic Test (RDT) and microscopic test. The results indicated that RDT had similar performance with microscopy for both positive and negative cases of malaria infection. Analyses for sensitivity, specificity and predictive values of RDT done stood at 98.9%, 97.1% and 96.9% respectively with reference to microscopic tests. The study further sought to determine the incident rates of malaria infections during wet and dry seasons among infants below five years and expectant females with febrile illnesses. Interestingly, incident rates of malaria were significantly high 47.4% during dry season than wet season 30.9%. The results showed that female children had 42.1% incidence higher than male children 30.8%. Further analysis of incident rate of malaria among children less than 5 years and expectant women gave (p < 0.05). There was significant difference in incident rate of malaria among children and expectant women with febrile illnesses p < 0.05, with children having higher incidence rate than expectant women that is 2 to 5 years at 52.34% followed by children less than one year at 41.41% and lowest in expectant mothers at 6.25%. Intensified protection strategies need to be adopted during the dry months of the year. The predominant Plasmodium species diagnosed from children and febrile patients attending Chuka Level Five Hospital was P. falciparum at 81.37% and P. vivax at 18.63%. P. falciparum is relatively higher than P. vivax which is likely to develop anti-malaria infections. In conclusion RDT is appropriate for the use of malaria diagnosis. The study recommends use of RDTs in mass screening for malaria infection, adopt or intensify protective measures during dry seasons and monitoring infections in children.