Rashid Ali, Muhammad Asrar, Salma Sultana, Amna Sajjad
Urine-based rapid diagnostic tests showed good agreement with blood-based tests, providing a practical non-invasive option for malaria screening in this setting. Further multicentre studies are recommended.
BACKGROUND: Urine-based rapid diagnostic tests offer a non-invasive alternative for malaria diagnosis; however, their use has not been evaluated in Faisalabad, Pakistan.
AIM: To assess the diagnostic accuracy of a urine-based rapid diagnostic test for detecting Plasmodium vivax and Plasmodium falciparum infections in Faisalabad, Pakistan.
METHODS: From January 2023 to December 2024, we collected and analysed laboratory samples from 360 febrile patients aged ≥5 years, with clinical symptoms suggestive of malaria, at a district headquarters hospital in Faisalabad, Punjab, Pakistan. We analysed the data using SPSS version 25 and used Cohen's kappa coefficient to assess the inter-test reliability agreement between blood- and urine-based rapid diagnostic tests.
RESULTS: Of the 360 participants, microscopy identified Plasmodium vivax in 216 (60.0%) cases, Plasmodium falciparum in 108 (30.0%), and mixed infections in 36 (10.0%). Blood-based rapid diagnostic tests showed higher positive predictive value than urine-based tests (94.3% vs 85.2%) and higher sensitivity. Overall agreement between tests was 91.1% (Cohen's kappa = 0.83).
CONCLUSION: Urine-based rapid diagnostic tests showed good agreement with blood-based tests, providing a practical non-invasive option for malaria screening in this setting. Further multicentre studies are recommended.