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Abstract
Prevalence estimates are critical for malaria programming efforts but generating these from non-malaria surveys is not standard practice. Malaria prevalence estimates for 6–59-month-old Nigerian children were compared between two national household surveys performed simultaneously in 2018: a Demographic and Health Survey (DHS) and the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). DHS tested via microscopy (n = 8298) and HRP2-based rapid diagnostic test (RDT, n = 11,351), and NAIIS collected dried blood spots (DBS) which were later tested for histidine-rich protein 2 (HRP2) antigen (n = 8029). National Plasmodium falciparum prevalence was 22.6% (95% CI 21.2– 24.1%) via microscopy and 36.2% (34.6– 37.8%) via RDT according to DHS, and HRP2 antigenemia was 38.3% (36.7–39.9%) by NAIIS DBS. Between the two surveys, significant rank-order correlation occurred for state-level malaria prevalence for RDT (Rho = 0.80, p < 0.001) and microscopy (Rho = 0.75, p < 0.001) versus HRP2. RDT versus HRP2 positivity showed 24 states (64.9%) with overlapping 95% confidence intervals from the two independent surveys. P. falciparum prevalence estimates among 6–59-month-olds in Nigeria were highly concordant from two simultaneous, independently conducted household surveys, regardless of malaria test utilized. This provides evidence for the value of post-hoc laboratory HRP2 detection to leverage non-malaria surveys with similar sampling designs to obtain accurate P. falciparum estimates.
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Details
1 United States Centers for Disease Control and Prevention, Malaria Branch, Division of Parasitic Diseases and Malaria, Atlanta, USA (GRID:grid.416738.f) (ISNI:0000 0001 2163 0069)
2 Institute of Human Virology Nigeria, Abuja, Nigeria (GRID:grid.421160.0)
3 National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria (GRID:grid.434433.7) (ISNI:0000 0004 1764 1074)
4 US President’s Malaria Initiative, Abuja, Nigeria (GRID:grid.434433.7)
5 United States Agency for International Development, Abuja, Nigeria (GRID:grid.434433.7)
6 US Centers for Disease Control and Prevention, Division of Global HIV and TB, Abuja, Nigeria (GRID:grid.434433.7)
7 Nigeria Centre for Disease Control, Abuja, Nigeria (GRID:grid.508120.e) (ISNI:0000 0004 7704 0967)
8 The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland (GRID:grid.452482.d) (ISNI:0000 0001 1551 6921)
9 US Centers for Disease Control and Prevention, Division of Global HIV and TB, Abuja, Nigeria (GRID:grid.452482.d)
10 US Centers for Disease Control and Prevention, Division of Global HIV and TB, Abuja, Nigeria (GRID:grid.508120.e)