Table 3.
Accuracy of routine malaria diagnosis compared with malaria disease*, stratified by transmission intensity and age categories
|
Very high transmission districts n/N,% (95% CI) |
Moderate-to-high transmission districts n/N,% (95% CI) |
All districts n/N,% (95% CI) |
|
| All age groups | |||
| Sensitivity | 150/175, 85.7 (79.6–91.8) | 172/184, 93.5 (89.9–97.1) | 322/359, 89.7 (86.1–93.3) |
| Specificity | 130/403, 32.3 (26.4–38.1) | 271/723, 37.5 (32.1–42.9) | 401/1126, 35.6 (31.6–39.6) |
| PPV | 150/423, 35.5 (30.8–40.1) | 172/624, 27.6 (23.4–31.8) | 322/1047, 30.8 (27.6–34.0) |
| NPV | 130/155, 83.9 (77.8–90.0) | 271/283, 95.8 (93.6–97.9) | 401/438, 91.6 (88.7–94.4) |
| Patients <5 years | |||
| Sensitivity | 90/104, 86.5 (79.7–93.4) | 93/98, 94.9 (90.6–99.2) | 183/202, 90.6 (86.4–94.8) |
| Specificity | 22/102, 21.6 (12.6–30.5) | 65/190, 34.2 (26.7–41.7) | 87/292, 29.8 (24.0–35.6) |
| PPV | 90/170, 52.9 (46.6–59.3) | 93/218, 42.7 (34.4–50.9) | 183/388, 47.2 (41.8–52.6) |
| NPV | 22/36, 61.1 (45.8–76.4) | 65/70, 92.9 (86.9–98.8) | 87/106, 82.1 (74.5–89.7) |
| Patients ≥5 years | |||
| Sensitivity | 60/71, 84.5 (75.2–93.9) | 79/86, 91.9 (86.1–97.6) | 139/157, 88.5 (83.3–93.7) |
| Specificity | 108/301, 35.9 (29.3–42.4) | 206/533, 38.7 (32.7–44.6) | 314/834, 37.7 (33.2–42.1) |
| PPV | 60/253, 23.7 (18.4–29.0) | 79/406, 19.5 (15.4–23.5) | 139/659, 21.1 (17.9–24.3) |
| NPV | 108/119, 90.8 (85.8–95.7) | 206/213, 96.7 (94.5–99.0) | 314/332, 94.6 (92.2–96.9) |
* Defined as any malaria parasitaemia on expert slide examination in patient with fever