Prevalence of Malaria Infection and Reliability of ACCUCARE One Step Malaria Test® for Diagnosing Malaria in People Living with Human Immunodeficiency Virus Infection in Cameroon

Abstract

Aims: This study aimed at determining the malaria prevalence and appraising the diagnostic performances of a rapid diagnostic test (RDT), namely ACCUCARE one step Malaria Test®, for malaria in people living with human immunodeficiency virus infection (PLWHIV). Study design:  This study was a cross-sectional study. Place and Duration of Study: The study was carried out at the District hospital of Deido in Douala, Cameroon between August 2015 and March 2016. Methodology: A total of 723 patients were included in the study. Malaria parasites were detected using Giemsa-stained blood films and RDT. The reliability of the RDT was evaluated by calculating the sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), accuracy and Kappa index (κ). Results were analyzed and compared using light Giemsa-stained blood films as gold standard. HIV infection was confirmed using methods based on immunochromatography and ELISA. CD4 lymphocytes count was determined by flow cytometry to depict the immune status. Results: Overall, Plasmodia were found in 121 (16.7%; 95%CI: 14.2%-19.6%) and 91 (12.6%; 95%CI: 10.3%-15.3%) using light microscopy and RDT respectively. The sensitivity, specificity, PPV and NPV of the RDT were 75.2% (95%CI: 66.8%-82.1%), 100% (95%CI: 99.4%-100%), 100% (95% CI: 95.9% -100%) and 95.3% (95% CI: 93.3% - 96.7%) respectively. The agreement between both methods was excellent (κ = 0.835; P < .0001). Conclusion: The study showed a good performance of the RDT in terms of specificity, PPV, NPV, accuracy and agreement. This test might represent a good alternative to the standard method for diagnosis of malaria in PLVIH.