Malaria Rapid Diagnostic Test Performance Compared to Microscopy in a Peripheral Health Centre in Adamawa State

Accurate diagnosis of malaria at peripheral health facility level is critical for rational drug use and patient management in Nigeria's Northeast geopolitical zone. This study evaluated the diagnostic performance of a malaria rapid diagnostic test compared to expert light microscopy as the reference standard in a peripheral health centre in Adamawa State. Three hundred febrile patients presenting with suspected malaria were enrolled over a six-month period. Both rapid diagnostic test and Giemsa-stained blood film examination were performed concurrently for each participant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using microscopy as the gold standard. The rapid diagnostic test demonstrated a sensitivity of 89.3 percent and specificity of 94.1 percent. False negative results were most common in patients with low-density parasitaemia below 100 parasites per microlitre. Equipment calibration and laboratory technician training levels were identified as significant determinants of microscopy accuracy at peripheral level. The study recommends regular quality assurance monitoring of rapid diagnostic test batches alongside periodic competency refresher training for laboratory staff at all healthcare tiers. Keywords: rapid diagnostic test, malaria microscopy, peripheral health centres, Adamawa State, diagnostic accuracy.