Stauffer WM, et al. Superior diagnostic performance of malaria rapid diagnostic tests as compared to blood smears for malaria in US clinical practice. Clin Infect Dis. 2009 Sep 15;49(6):908-13.
Objective: To compare the predictive value of a rapid diagnostic test with traditional thick and thin blood smears for malaria diagnosis.
Summary result: In clinical lab conditions, the rapid test was superior to the single set of blood smears for diagnosis or exclusion of malaria, and the rapid test specifically achieved a 100% negative predictive value for Plasmodium falciparum.
Methods: Prospective study three hospital-based labs of 852 consecutive samples sent for thick and thin blood smears to test for malaria 2003-2006. PCR was the reference standard. Each sample was submitted for thick and thin smear and the rapid antigen capture assay. All personnel were blinded to other test results and no person performed more than one test type.
Results: 103 specimens tested positive for malaria, and 95 were confirmed by PCR. Table 1 (p. 910) compares the predictive values and likelihood ratios for all malria, as well as specific species. For all malaria, sensitivity of rapid test v. blood smear was 97% v. 85%. Negative predictive value for the rapid test was 98% and for the blood smear was 93%.