Assessing the Performance of CareStart™ Malaria Rapid Diagnostic Tests in Northwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: While rapid diagnostic tests are an alternative diagnostic tests for microscopy in the diagnosis of malaria in rural settings, their performance has been inconsistent. Performance of rapid diagnostic tests might be affected by manufacturing process, transportation and storage, parasitemia level, and skill of personnel who perform the tests. Therefore, periodic evaluation of the local field performance of rapid diagnostic tests is mandatory in order to make early corrections in case of decreased performance. METHODS: A facility-based cross-sectional study was conducted from January to May 2020 among 257 malaria-suspected patients attending selected health centers in Bahir Dar Zuria district. Capillary blood was collected from each participant and tested for Plasmodium infection by CareStart™ rapid diagnostic test kit and thin and thick blood film microscopy. Data were analyzed using statistical software for social sciences version 20 and MedCalc software version 19.3. Sensitivity, specificity, positive and negative predictive values, and kappa value were calculated to evaluate the performance of rapid diagnostic tests against microscopy. RESULTS: Among 257 study participants, 47 (18.3%) were tested positive for Plasmodium infection by at least one of the diagnostic methods. Rapid diagnostic tests revealed 3 false positive and 3 false negative results. The sensitivity and specificity of CareStart Malaria Pf/Pv Combo test were 93.2% and 98.6%, respectively (kappa = 0.918). CONCLUSION: CareStart™ rapid diagnostic test has comparable performance with microscopy for malaria diagnosis. We recommend continued use of CareStart Malaria Pf/Pv Combo test at health posts in Ethiopia where microscopy is not available.

Prevalence of Malaria and Associated Knowledge, Attitude, and Practice among Suspected Patients in Bahir Dar Zuria District, Northwest Ethiopia.

BACKGROUND: Control and prevention activities have brought substantial decline of malaria incidence in the last two decades in Ethiopia. However, lack of local data on the disease transmission and community knowledge, attitude, and practice about malaria are thought to reverse the trend of malaria in certain areas. Therefore, assessment of the prevalence and community awareness towards malaria plays pivotal role for the success of malaria control and prevention. OBJECTIVE: To assess malaria prevalence and knowledge, attitude, and practice about malaria among febrile patients in Bahir Dar Zuria district, Northwest Ethiopia. METHODS: A facility based crosssectional study was conducted from January to March 2020 among 149 febrile patients attending selected health centers in Bahir Dar Zuria district. Data about knowledge, attitude, and practice about malaria were collected using semistructured questionnaire. Blood sample from each participant was tested for Plasmodium species through malaria rapid diagnostic tests and blood film microscopy. Data were analyzed using statistical software for social sciences version 20. RESULTS: Among 149 participants, 22 (14.8%) were positive for Plasmodium infection at least by one diagnostic methods. Prevalence of P. falciparum and P. vivax was 3.4% and 10.1%, respectively, while that of mixed infection was 1.3%. From the total study participants, 29.5% have good knowledge, 77.2% have positive attitude, and 34.9% have good practice towards malaria. Statistically significant associations were observed on knowledge with age group (X 2 = 10.377, P = 0.035), educational level (X 2 = 15.075, P = 0.001), family size (X 2 = 7.601, P = 0.022), attitude level and practice level. Participants with family size < 5 were 6.841 (95% CI: 2.570-18.206, P ≤ 0.001) times more likely to have negative attitude as compared to those with family size ≥ 5. CONCLUSIONS: Prevalence of malaria in the study area was relatively high. Study participants had encouraging attitude; however, their knowledge and practice towards malaria were poor. Therefore, the existing malaria control activities should be supplemented with continuous health educations, aware the community, and ensure participation in the control and prevention activities.

Species Composition, Parous Rate, and Infection Rate of Anopheles Mosquitoes (Diptera: Culicidae) in Bahir Dar City Administration, Northwest Ethiopia.

Anopheles mosquitoes are the main vectors of malaria. There is little information on the current entomological aspects of Anopheles mosquitoes in Amhara region of northwestern Ethiopia. Therefore, the aim of this study was to assess the prevailing species composition, parous rate, and infection rate of Anopheles mosquitoes in the Bahir Dar city administration. A community-based cross-sectional study was conducted from January through July 2020. For this, six Centers for Disease Control and Prevention light traps (three traps indoor and three traps outdoor) were used to collect adult female Anopheles mosquitoes. The species were morphologically identified, and the parous and infection rates were determined via dissection of ovaries and salivary gland, respectively. A total of 378 adult female Anopheles mosquitoes comprised of three species (Anopheles d'thali, Anopheles rhodesiensis, and Anopheles gambiae complex) were collected and identified at the study sites. Anopheles rhodesiensis was the predominant species accounting for 90% of all collections at the Zenzelima site, followed by An. gambiae complex (6.5%). In contrast, An. gambiae complex was the predominant species at the Tis Abay site, comprising 94% of captures. The overall parous and infection rates were 35 (62.5%) and 1 (2.9%), respectively.