Usefulness of an inexpensive, Paracheck® test in detecting asymptomatic infectious reservoir of Plasmodium falciparum during dry season in an inaccessible terrain in Central India

Abstract

Objectives: The performance of a new indigenous rapid diagnostic test, Paracheck Pf® was evaluated in detection of Plasmodium falciparum in asymptomatic children in remote forest villages of Mandla district, central India to determine the lower limits of sensitivity and specificity of rapid test. Methods: A finger prick blood sample was collected to prepare blood smear and for testing with the Paracheck test. The blood smears were read by an experienced technician blinded to the Paracheck results. The figures for specificity, sensitivity, accuracy and predictive values were calculated using microscopy as gold standard. Results: The new diagnostic test had a sensitivity of 94% and a specificity of 89%. The positive and negative predictive values were 71% and 98%, respectively. The J-index was 0.83%. Conclusion: The rapid test was found to be very easy to perform and the result could be read reliably by field workers. The field evaluation with this new inexpensive test, ($0.65/test) indicates that it could be used as an epidemiological tool in the management of malaria particularly in areas where microscopy is not operationally feasible to attain the goal of the roll back malaria initiative.