SD bioline malaria rapid diagnostic test performance and time to become negative after treatment of malaria infection in southwest Nigerian children

Context and Aim: Given the challenges of microscopy, we compared its performance with SD Bioline malaria rapid diagnostic test (MRDT) and polymerase chain reaction (PCR) and evaluated the time it took for positive results to become negative after treatment of children with acute uncomplicated malaria. Subjects and Methods: We present the report of 485 participants with complete MRDT, microscopy, and PCR data out of 511 febrile children aged 3­59 months who participated in a cohort study over a 12 month period in rural and urban areas of Ibadan, Nigeria. MRDT positive children received antimalaria and tested at every visit over 28 days. Speciation was also carried out by PCR. Results: With microscopy as the gold standard, SD-Bioline™ had 95.2% sensitivity, 66.4% specificity, 67.5% positive predictive value (PPV), and 94.9 negative predictive value (NPV), while with PCR the findings were 84.3% sensitivity, 66.5% specificity, 72.7% PPV, and 80.1% NPV. PCR speciation of malaria parasites revealed 91.6% Plasmodium falciparum, 18.9% Plasmodium malariae, and 4.4% Plasmodium ovale. Among the 47 children with P. malariae infections, 66.0% were coinfected with P. falciparum, while 54.6% cases of P. ovale occurred as coinfections with P. falciparum. The median time to a negative MRDT was 23.2 days, while the median time to a negative malaria microscopy was 3.8 days. The two survival curves were significantly different. Conclusions: The SD BiolineTM MRDT performed well, with remarkable persistence of rapid test-positive for an average of 23 days post treatment. The prevalence of P. malaria is somewhat greater than expected.

Constraints to Attending the Maternal, Newborn and Child Health Weeks in North West Nigeria.

Objectives: This study aimed to understand the barriers to MNCHW attendance in order to develop recommendations for strengthening its social mobilization activities. Methods: In the states of Jigawa and Zamfara in northern Nigeria, 19 in-depth interviews were conducted with government officials and community leaders; and 36 focus group discussions with women with a child under 5-years of age, their husbands, town criers, health workers, community volunteers, and religious leaders on MNCHW social mobilization and barriers to attendance. Content analysis was used to derive themes. Results: Awareness of MNCHW was low among the target beneficiaries. Even where programme awareness existed, there was little understanding of the nutrition and health benefits of VAS. Social mobilization focused solely on raising awareness about the dates and location of MNCHW, it did not promote its health benefits. MNCHW has also been overshadowed by the Immunization Plus Days (IPDs) which are conducted monthly. Other barriers to MNCHW attendance included inability to afford transportation costs, and distrust of government programmes. Conclusions: To increase attendance at MNCHW in northern Nigeria, social mobilization must first address the lack of understanding of the health benefits of the MNCHW programme.