Assessing the Diagnostic Accuracy of Malaria Rapid Diagnostic Tests in Comparison with the Gold Standard in Detecting Malaria Infections among Patients Seeking Medicare at a Selected County Referral Hospital in Western Kenya

Abstract

Background: Malaria remains a major global health challenge predominantly affecting sub-Saharan Africa, which accounts for 95% of cases and 96% of malaria related deaths worldwide. Early and accurate diagnosis is essential for effective disease management and control. This study examined the diagnostic accuracy of Malaria Rapid Diagnostic Tests (RDTs) in detecting malaria infections among patients at Nyamira County Referral Hospital and explores potential associations between RDT results and demographic factors such as age and gender. Materials and Methods: A cross-sectional field study was conducted involving 309 participants out of 352 eligible patients (response rate 87.7%) presenting with symptoms suggestive of malaria. Both RDTs and microscopy were employed to detect Plasmodium infections. Diagnostic performance metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Associations between demographic factors and RDT outcomes were also analyzed.  The data was exported to SPSS statistical software for analysis. Cross tabulations, the Median and the Interquartile range statistics were determined for the various tests and compared with one another.  Results: The RDTs demonstrated an overall diagnostic accuracy of approximately 92.8%, with sensitivity of 94.5% and specificity of 87.1%. These results indicate a high ability of RDTs to correctly identify both malaria-positive and malaria-negative cases. No significant associations were found between RDT results and patient age or gender, suggesting consistent test performance across demographic groups. Conclusion: Based on these findings, Malaria RDTs are reliable for routine malaria screening in healthcare settings such as Nyamira County Referral Hospital.