Comparative Performance of Blood and Urine Malaria Rapid Diagnostic Tests in Detecting Malaria in Febrile Children: A Cross-Sectional Analysis.

Background: This study aimed to determine the usefulness of the urine based malaria rapid diagnostic test (RDT) in clinical settings. Methods: All participants had blood and urine samples tested. To assess RDT performance, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: The malaria positivity rates were 67.4% for the SD Bioline RDT, 65.3% for the CareStart RDT, and 45.3% for the Fyodor UMT. There was an excellent agreement between the SD Bioline and CareStart malaria RDTs (Cohen's kappa of .859). There was moderate agreement between the Fyodor UMT and the 2 blood-based RDTs, with a kappa of .491 (P < .001). The Fyodor UMT had sensitivity, specificity, PPV, and NPV of 58.6%, 100.0%, 100.0%, and 40.0%, respectively. Conclusion: The urine-based malaria test kit may have limited utility as a standalone diagnostic tool for malaria in febrile children, due to its relatively low sensitivity.