Varying Malaria Rapid Diagnostic Test Accuracy by Regional Transmission Level and Demographics in Tanzania
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Date
2025-12-04
Journal Title
Journal ISSN
Volume Title
Publisher
The American Journal of Tropical Medicine and Hygiene
Abstract
Malaria remains a significant global health burden, with �263 million cases across 83 countries. It is essen-
tial to quickly and accurately detect cases to control the spread of the disease. Given the widespread use of malaria rapid
diagnostic tests (mRDTs) for case management and surveillance, it is crucial to understand test reliability. Clarifying how
mRDT results differ from real-time polymerase chain reaction (qPCR) test results, as well as the nature of additional vari-
ance by test manufacturer, will be useful for reducing measurement bias. After comparing three national standard mRDTs
and a research mRDT with qPCR results from a 2021 cross-sectional study in Tanzania, differences were found in terms
of age, sex, and regional malaria transmission rate. The research test underperformed overall, with poor sensitivity across
transmission strata. After comparing the research mRDT to standard mRDTs, the odds ratios indicated that transmission
intensity may affect mRDT agreement and diagnostic performance. These results offer pertinent information on test
accuracy and decrease outcome misclassification for malaria prevalence.