SynthesisMalaria journal2025
Performance of rapid diagnostic tests for malaria diagnosis in Nigeria: a systematic review and meta-analysis.
Synthesis in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
Funding
Abstract
backgroundMalaria remains a significant public health challenge in Nigeria, where diagnostic accuracy is essential for effective treatment and management. This systematic review and meta-analysis aimed to compare the diagnostic performance of malaria rapid diagnostic tests (RDTs) with that of microscopy, the gold standard for malaria diagnosis, in Nigeria.
methodsA systematic search of Medline (PubMed), Scopus, Web of Science, and Google Scholar and other manually searched articles yielded 502 records. After removing duplicates and screening, 15 studies met the inclusion criteria for the meta-analysis. The risk of bias and applicability were assessed via QUADAS-2. A random effects model was used to pool sensitivity, specificity, positive and negative likelihood ratios (LR + , LR-), diagnostic odds ratios (DORs), and summary receiver operating characteristic (SROC) curves, with analysis conducted via Meta-Disc 1.4 and the metafor package (version 4.6-0) in R (version 4.4.1). Publication bias was assessed via funnel plots and Egger's test. Leave-one-out sensitivity analyses were conducted to assess the robustness of pooled estimates.
resultsThe pooled sensitivity of RDTs was 69.7% [95% confidence interval (CI)]: 67.7-71.6%, and the specificity was 81.5% (95% CI 79.9-83.1%). The DOR was 21.87 (95% CI 7.45-64.21). The SROC curve was 0.902, though heterogeneity was high (I
conclusionMalaria RDTs in Nigeria show suboptimal sensitivity and specificity compared with WHO benchmarks. While RDTs remain the most practical frontline tool due to their accessibility and ease of use, their limitations highlight the need for strengthened diagnostic algorithms that integrate RDTs with microscopy or molecular methods where feasible. Leave-one-out sensitivity analyses confirmed the robustness of the pooled estimates, reinforcing the validity of the conclusions. Advancing RDT technology, improving microscopy practices, and ensuring consistent study reporting are essential to enhance malaria diagnosis and control efforts.
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