A Comparative Analysis of Four Different Diagnostic Techniques for Malaria

Abstract

Introduction: Malaria is one of the major parasitic diseases and laboratory diagnosis of malaria infection requires the availability of a rapid, sensitive, and specific test that is affordable. There is the availability of several laboratory procedures for malaria diagnosis. Aim: To compare the performance of conventional microscopy using leishman staining against an immunochromatographic antigen detection test, fluorescent microscopy using Acridine Orange (AO), and molecular technique by Polymerase Chain Reaction (PCR) in the laboratory diagnosis of malaria. Materials and Methods: In the present cross-sectional study, 432 specimens were collected from patients suspected of malaria attending Dr. Susheela Tiwari Government Hospital, Haldwani, Uttarakhand, India, during the study period from January 2018 to September 2019. Microscopic examinations of Leishman stained smears, immunochromatographic Rapid Diagnostic Test (RDT), fluorescent microscopy using AO, and PCR were done using appropriate statistical analysis. Results: Out of the 432 specimens tested, a total of 208 (48.2%) were found positive for malaria using all four tests. Microscopy using leishman staining, RDT, and fluorescent microscopy were performed on all samples out of which 180 (41.6%) samples showed a positive result on Leishman staining, 186 (43%) were detected using AO fluorescent microscopy while the RDT had a yield of 208 (48.2%) positive results for malaria. While PCR was performed on 124 samples that yielded 79 (63.7%) positive results. Conclusion: Though, peripheral blood smears are still considered the gold standard for malaria diagnosis. But, in this study, it was observed that newer RDT for malaria surpassed the diagnostic efficacy of clinical microscopy and hence, has a superior role in clinical practice and diagnosis.