Diagnosis of malaria by the rapid manual test

The diagnosis of malaria is based on the finding of malaria parasites in blood. Until now the diagnosis is carried out by, means of the conventional method using Giemsa stained of a blood smear (thin or thick) and then examined by ordinary light microscope. In this study a Rapid Manual Test (RM test) for diagnosing malaria was introduced. The test was simpler than the conventional method and did not need staining as well as microscope. The test could detect soluble Plasmodium falciparum antigen of the trophozoite stage which consisted mainly of histidine-rich-protein-II (HRP-II). This test is a “dipstick test” which contains monoclonal antibody against HRP-IL In this study blood samples were collected from patients who were treated at the International Timber Corporation Indonesia (ITCI) Hospital at Kenangan, Balikpapan, East Kalimantan, an endemic area for malaria. The aim of this study was to know the sensitivily and specificity of the RM test in detecting P.falciparum infection and comparing to the conventional diagnostic, method. Based on I 17 blood smears examined, 33.3% were positive for malaria falciparum whereas 53.0% were negative by both methods. However l3-7% blood smears showed different results: 93.8% were positive with the RM test but were negative with the conventional, method, whereas 6.2% were negative with the RM test but positive with the conventional method. By statistical analysis it was shown that the sensitivity and specificity of the RM test were 97.5% and 80.5% respectively. The major clinical symtoms of the 60 patients examined were headache (42.9%) followed by chills (42.6%), fever above 37.5° C (37.5%), nausea or vomiting (45.8%) and the RM test positive rate was 44.2%. Fifty percent of the patients showed splenomegaly whereas 45.5% showed anemic conjunctivae. It was concluded that the RM test could replace the conventional method. It did not need a microscope and was quite sensitive for diagnosing malaria falciparum. Furthermore it could be applied in small peripheral hospitals where microscopes and malaria mcroscopist are not available.