Abstract:
Objectives: Rapid diagnostic tests (RDTs) offer an attractive tool for diagnosing malaria in pregnancy. This study
assessed the effectiveness of a Plasmodium falciparum–specific RDT compared with microscopy and polymerase
chain reaction (PCR) in diagnosing asymptomatic malaria in pregnant women in southwest Nigeria.
Methods: The study included 406 asymptomatic pregnant women seeking antenatal care. Blood samples were
collected and tested using RDT (SD Bioline, Standard Diagnostics Inc. Korea) and light microscopy and confirmed
using nested PCR.
Results: The study revealed that the malaria parasite positivity rate was 8.9% by RDT, 21% by microscopy,
and 32% by nested PCR. RDT had a sensitivity of 51.4% and specificity of 69.5%, whereas microscopy had a
sensitivity of 65.3% and specificity of 98.2%. The combined testing of microscopy and RDT had a sensitivity and
specificity of 100%. The study also showed a high prevalence of mild anemia among participants.
Conclusions: Despite the RDT’s low sensitivity, its high negative predictive value suggests it could be useful in
combination with microscopy in ruling out asymptomatic malaria in pregnancy. Further study will help identify
more suitable RDTs for routine malaria diagnosis in Nigeria and strengthen malaria prevention programs in
pregnant women.
