Table 4 Comparative performance of Rapid Diagnostic Test kits (Parascreen, Falcivax, Malascan, First Response and ParaHIT Total) with traditional light microscopy and Polymerase Chain Reaction (PCR) for diagnosis of P.vivax

Light Microscopy as Gold Standard (Reference)

Sensitivity

77.2

68.4

68.4

84.2

15.8

(95% CI)

(64.2-87.3)

(54.8-80.1)

(54.8-80.1)

(72.1-92.5)

(7.5-27.9)

Specificity

98.1

99.0

97.8

96.5

100.0

(95% CI)

(95.9-99.3)

(97.2-99.8)

(95.5-99.1)

(93.8-98.2)

(98.8-100.0)

Positive Likelihood Ratio

40.5

71.8

30.8

24.1

(95% CI)

(18.1-90.6)

(23.0-224.6)

(14.5-65.4)

(13.4-43.6)

Negative Likelihood Ratio

0.23

0.32

0.32

0.16

0.84

(95% CI)

(0.14-0.37)

(0.22-0.47)

(0.22-0.47)

(0.09-0.30)

(0.75-0.94)

Positive Predictive Value

88.0

92.9

84.8

81.4

100.0

(95% CI)

(75.7-95.5)

(80.5-98.5)

(71.1-93.7)

(69.1-90.3)

(66.4-100.0)

Negative Predictive Value

96.0

94.5

94.5

97.1

86.8

(95% CI)

(93.2-97.8)

(91.5-96.7)

(91.4-96.7)

(94.6-98.7)

(82.9-90.1)

Percentage Agreement (Accuracy)

94.9

94.4

93.3

94.6

87.1

Kappa

0.80

0.76

0.72

0.80

0.24

PCR as Gold Standard (Reference)

Sensitivity

68.3

61.7

63.3

76.7

13.3

(95% CI)

(55.0-79.7)

(48.2-73.9)

(49.9-75.4)

(64.0-86.6)

(5.9-24.6)

Specificity

97.0

98.4

97.4

95.7

99.7

(95% CI)

(94.5-98.6)

(96.2-99.5)

(94.9-98.9)

(92.8-97.7)

(98.2-100.0)

Positive Likelihood Ratio

23.1

37.5

24.1

17.9

40.5

(95% CI)

(11.9-44.9)

(15.4-91.5)

(11.8-49.0)

(10.4-31.1)

(5.2-318.1)

Negative Likelihood Ratio

0.33

0.39

0.38

0.24

0.87

(95% CI)

(0.22-0.47)

(0.28-0.54)

(0.27-0.53)

(0.15-0.39)

(0.79-0.96)

Positive Predictive Value

82.0

88.1

82.6

78.0

88.9

(95% CI)

(68.6-91.4)

(74.4-96.0)

(68.6.-92.2)

(65.3-87.7)

(51.8-99.7)

Negative Predictive Value

93.9

92.9

93.1

95.4

85.4

(95% CI)

(90.7-96.3)

(89.5-95.4)

(89.7-95.6)

(92.4-97.5)

(81.2-88.9)

Percentage Agreement (Accuracy)

92.3

92.3

91.8

92.6

85.4

Kappa

0.70

0.68

0.67

0.73

0.20