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Malaria Research and Treatment
Volume 2016, Article ID 5242498, 7 pages
Research Article

Cost-Effectiveness and Validity Assessment of Cyscope Microscope, Quantitative Buffy Coat Microscope, and Rapid Diagnostic Kit for Malaria Diagnosis among Clinic Attendees in Ibadan, Nigeria

1Nigeria Field Epidemiology and Laboratory Training Program, Abuja 900231, Nigeria
2Department of Medical Microbiology, University College Hospital, Ibadan 200281, Nigeria
3Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan 200281, Nigeria
4Department of Medical Microbiology, Ahmadu Bello University, Zaria 810105, Nigeria
5Department of Medical Microbiology, College of Medicine, University of Lagos, Lagos 100283, Nigeria
6National Malaria Elimination Program, Federal Ministry of Health, Abuja 900211, Nigeria

Received 22 April 2016; Accepted 15 June 2016

Academic Editor: Polrat Wilairatana

Copyright © 2016 Abiodun Ogunniyi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Unavailability of accurate, rapid, reliable, and cost-effective malaria diagnostic instruments constitutes major a challenge to malaria elimination. We validated alternative malaria diagnostic instruments and assessed their comparative cost-effectiveness. Method. Using a cross-sectional study design, 502 patients with malaria symptoms at selected health facilities in Ibadan between January and April 2014 were recruited consecutively. We examined malaria parasites using Cyscope®, QBC, and CareStart and results were compared to light microscopy (LM). Validity was determined by assessing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Costs per hour of use for instruments and turnaround time were determined. Result. Sensitivity of the instruments was 76.0% (CareStart), 95.0% (Cyscope), and 98.1% (QBC). Specificity was 96.0% (CareStart), 87.3% (Cyscope), and 85.5% (QBC). PPV were 65.2%, 67.5%, and 84.7%, while NPV were 93.6%, 98.6%, and 99.4% for CareStart, Cyscope, and QBC with Kappa values of 0.75 (CI = 0.68–0.82) for CareStart, 0.72 (CI = 0.65–0.78) for Cyscope, and 0.71 (CI = 0.64–0.77) for QBC. Average cost per hour of use was the lowest ($2.04) with the Cyscope. Turnaround time was the fastest with Cyscope (5 minutes). Conclusion. Cyscope fluorescent microscope had the shortest turnaround time and is the most cost-effective of all the malaria diagnostic instruments evaluated.