Malaria Laboratory Diagnostic Performance: Case studies of two health centers in Zomba, Malawi

The objective of the study was to establish the performance of malaria laboratory diagnostics in routine clinical setting of health facilities in Zomba, Malawi. 246 suspected malaria cases in Matawale and Domasi Health Centers in October-November 2009 and 2010 were tested using two diagnostics methods(rapid diagnostic test ( RDT )and Microscopy 144 patients who reported fever in 2009, 52% were referred to the laboratory for malaria test. The positive predictive value for microscopy in this study was 0.86. The study revealed that microscopy missed (30%) and (28%) in 2009 and 2010 respectively and this attributed to challenges with microscopy. RDT missed only 2 of malaria cases results between the two tests performed in the study among the microscopy positives. Microscopy had a lower sensitivity of 70% while Paracheck PfHRP-2 rapid test 91.3%. In conclusion, microscopy produced a low sensitivity when compared to rapid diagnostic test