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International Journal of HIV and AIDS research
International Conference on
&
Sexually Transmitted Diseases, AIDS and Parasitic Infections
Parasitology, Infectious Diseases, STDs and STIs
September 21-22, 2017 San Antonio, TX, USA
Evaluation of performance of Deki reader of rapid diagnostic test for malaria diagnosis
in rural military health facilities in Tanzania
Akili Kalinga1,6, Charles Mwanziva3, Christopher Mswanya3, Deus Ishengoma 1, Lucky Temu2, Lucas Mahikwano2, Saidi Mgata2,
George Amoo6, Lalaine Anova4, Eyako Wurrapa 4, Nora Zwingerman5, Santiago Fero5, Geeta Bhat5, Ian Fine5, Mark Hickman4, Colin
Ohrt4 and Reginald Kavishe7
1National Institute for Medical Research, Tanzania
2Henry Jackson Foundation Medical Research International, Tanzania
3Tanzania Peoples Defense Force, Tanzania
4Walter Reed Army Institute of Research, USA
5Fio Corporation, Canada
6Amethysist Technologies LLC, USA
7Kilimanjaro Christian Medical University College, Tanzania
Introduction: Although Microscopy is a standard diagnostic tool for malaria, is used at minimal with unreliable
results because of unavailability of laboratory facilities in poor resource countries. Malaria Rapid diagnostic
Tests (mRDTs) are currently advocated and used as adjunct to microscopy. However, at very low parasitaemia
(<100 p/µl) the test line on mRDT is very weak to be seen and consequently affecting interpretation of test
results and patient care. Fio Corporation in Canada has developed a ruggedized portable, universal Deki Reader
of mRDTs (DR of mRDTs) to perform automatic analysis and interpretation of RDT. However, before deploying
the device for medical care in Tanzania, we evaluated its performance against microscopy as a reference test and
compared to human interpretation of mRDTs.
Methods: The cross-sectional study employed 1,293 outpatients with fever who were recruited and tested for
malaria using mRDT and microscopy techniques. Finger prick blood was prepared on mRDTs according to
manufacturer’s instructions and test performed as guided DR of mRDT. Thick and thin blood smears were also
prepared as guided by standardized template, stained and read by specialized Microscopist. We compared the
performance of DR of mRDT to human interpretation of mRDT against microscopy as gold standard
Results: Positivity rates by mRDT were 59.9% (775/1293) and 60.1% (777/1293) as interpreted by Human and
DR respectively; parasitaemia prevalence by microscopy as reference test was 48.4% (626/1293). The sensitivity
of mRDTs interpreted by DR was 94.1% and that of manual interpretation was 93.9%. The specificity of DR of
mRDT was 71.8% and that of human was 72.0 %. Positive Predictive Value (PPV) of mRDT by DR and human
was 75.8% and 75.4% respectively. The negative predictive value (NPV) of mRDT by DR was 92.8% and by
human was 92.4%. There was no significance difference in sensitivity, specificity, PPV, NPV and accuracy of
mRDT interpreted by DR and that of human interpretation
Conclusion:Theperformanceof DRin interpretingmRDTswas found tobe similar tohumanmanual interpretation.
There is a need to conduct more evaluations of performance of the device in different epidemiological settings
and by using other type of mRDT assays for malaria diagnosis before validating its use in Tanzania.