Aims/hypothesis: Malaria morbidity and mortality can be prevented or minimized by rapid diagnosis and treatment. Blood based rapid diagnostic tests (bRDT) for malaria are currently in use but other body fluids specific diagnostic test kits are being developed. One of these tests is Urine Malaria Test (UMT) dipstick, it is a one-step test used to detect Histidine Rich Protein 2 (HRP2), a polyhistidine antigen of plasmodium falciparum (Pf) in urine of affected patients. The aim of the present study was to evaluate the role of UMT in diagnosis of Pf malaria and its ability to detect the limits of Pf parasitemia in febrile patients admitted to Abbasia Fever Hospital, Egypt.
Methods: This study was conducted on 52 Pf malarial patients who were admitted to Abbassia Fever Hospital. Patients were subjected to meticulous history taking, clinical examination, routine laboratory investigations, abdominal ultrasound, blood film microscopy for malaria, rapid blood test (RBT) and UMT. Confirmed Pf malaria in the studied patients was based on the presence of positive parasite-based tests (+ve blood film microscopy with/without RBT for Pf malaria).
Results: The UMT was positive in 50% of cases with 50% false negative results in parasitologically confirmed Pf malarial patients. Sixteen patients presented with parasitemia ≤0.5% (ranged between 0.1% to ≤0.5%) in thick blood film and there was non-significant difference between positive and negative UMT in these patients [43.75% of cases were +ve versus 56.25% -ve test (p=0.280) with sensitivity (55.56%), specificity (71.43%) and accuracy (62.5%)]. The +ve UMT results were significantly related to higher parasitemia, lower Glasgow coma scale, lower platelet count and severe disease.
Conclusion: The UMT is simple, easy, self-performed and promising test in diagnosis of Pf malaria, however the sensitivity & specificity were apparently low.
Keywords: Falciparum malaria, UMT