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Biomédica
Print version ISSN 0120-4157
Abstract
CORTES, Liliana Jazmín and GUERRA, Ángela Patricia. Concordance analysis of three diagnostic tests for malaria in the symptomatic population of Colombian endemic municipalities. Biomédica [online]. 2020, vol.40, n.1, pp.117-128. ISSN 0120-4157. https://doi.org/10.7705/biomedica.4893.
Introduction:
Taking into account the difficulty of performing malaria microscopic diagnosis in rural areas, rapid diagnostic tests (RDT) are a good alternative, but it is important to verify their diagnostic performance.
Objective:
To evaluate the diagnostic performance of the RDTs used in five Colombian departments by comparing them with the microscopic diagnosis and using PCR as the reference standard.
Materials and methods:
Thick blood film and RDTs were used to diagnose symptomatic individuals; additionally, the filter paper was impregnated with blood for the molecular test.
Results:
We included 314 samples whose percentage of positivity for malaria was 49% by PCR, 48% by microscopy and 46% by RDT; parasitemia ranged between 180 and 23,800 p/µl of blood.
The concordance of the results from the microscopy units and those of the PCR (National Laboratory of Reference) was as follows: Cohen's kappa coefficient, 0.975 (95% CI: 0.9500.999); sensitivity, 97% (95% CI 95-100); specificity 100% (95% CI: 100-100), and kappa index of species, 0.958 (IC95%: 0.912-1.00).
The concordance between the Pf/Pv RDT (at the microscopy units) and the PCR (National Laboratory of Reference) was as follows: kappa coefficient, 0.878 (95% CI: 0.784-0.973); sensitivity, 94% (95% CI: 87-100); specificity, 95% (95% CI: 90-100), and kappa index of species, 1.0 (95% CI: 1.00-1.00).
The concordance between the Pf/Pan RDT versus PCR was: Cohen's kappa coefficient, 0.920 (95 % CI: 0.865- 0.974); sensitivity, 94% (95% CI: 90-98); specificity, 99% (95% CI 95-100), and kappa index of species, 0.750 (IC95% 0,637-0,863).
Conclusion:
The results of this study support the use of RDTs in Colombia; however, more training of the personnel is required to accurately differentiate Plasmodium species.
Keywords : Malaria/diagnosis; microscopy; polymerase chain reaction; Colombia.