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This systematic review and meta-analysis aimed to compare the diagnostic performance of malaria rapid diagnostic tests (RDTs) with microscopy, the gold standard, in Nigeria. Methods Searches in Medline (PubMed), Scopus, Web of Science, and Google Scholar identified 502 records, with 15 studies included; QUADAS-2 assessed bias and applicability. A random-effects model pooled sensitivity, specificity, likelihood ratios, DORs, and SROC curves, analyzed using Meta-Disc and R. Publication bias used funnel plots and Egger’s test, with leave-one-out sensitivity analyses. Results RDTs showed pooled sensitivity 69.7% and specificity 81.5%, with DOR 21.87 and SROC 0.902, but high heterogeneity (I2=96.8%) and evidence of publication bias. Subgroup analysis indicated regional variability, with better urban performance, and robustness was supported by leave-one-out ranges. Conclusion Malaria RDTs in Nigeria show suboptimal sensitivity and specificity versus WHO benchmarks, indicating a need to strengthen diagnostic algorithms integrating RDTs with microscopy or molecular methods where feasible.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/performance-of-rapid-diagnostic-tests-for-malaria-diagnosis-in-nigeria-a-systematic-review-and-meta-analysis/460045/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/performance-of-rapid-diagnostic-tests-for-malaria-diagnosis-in-nigeria-a-systematic-review-and-meta-analysis/460045.png","ImageObject",300,407,{"name":92,"@type":93},"Franzy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What was the main objective of the systematic review and meta-analysis?","Question",{"text":113,"@type":114},"To compare the diagnostic performance of malaria rapid diagnostic tests (RDTs) with microscopy, regarded as the gold standard, for malaria diagnosis in Nigeria.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which studies and databases were used to identify eligible evidence?",{"text":118,"@type":114},"A systematic search of Medline (PubMed), Scopus, Web of Science, and Google Scholar plus other manually searched articles yielded 502 records, and 15 studies met inclusion criteria for the meta-analysis.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the pooled diagnostic performance results for RDTs?",{"text":122,"@type":114},"RDTs had pooled sensitivity of 69.7% and specificity of 81.5%, with a DOR of 21.87 and an SROC curve area of 0.902; heterogeneity was high (I2=96.8%).",{"name":124,"@type":111,"acceptedAnswer":125},"What did the review conclude about using RDTs in Nigeria?",{"text":126,"@type":114},"RDTs showed suboptimal sensitivity and specificity compared with WHO benchmarks; despite being practical for frontline use, limitations support strengthening diagnostic algorithms by integrating RDTs with microscopy or molecular methods when feasible.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},460045,1790926128,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":144,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":145,"language":146,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":147,"faqs":148,"seo_title":149,"seo_description":67,"update_tm":150,"read_time":151,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Ismail et al. Malaria Journal (2026) 25:17 [https://doi.org/10.1186/s12936-025-05680-4](https://doi.org/10.1186/s12936-025-05680-4)  \nMalaria Journal  \n REVIEW Open Access  \nPerformance of rapid diagnostic tests for malaria diagnosis in Nigeria: a systematic review and meta-analysis  \nMubarak Ismail1,2,3, Alameen Mukhtar 1,2,3, Ismail Ayoade Odetokun4, Mohammed Auwal Ibrahim5, Abdulmalik Abdullahi Salman5, Hafsatu Garba Bawa-Sani6, Shafique Sani Nass7, Baba Waru Goni3, Abdulkadir Nuhu8, Xiaoying Zhang1, Aminu Usman2* and Murtala Bindawa Isah 1,2,3*  \nAbstract  \nBackground Malaria remains a significant public health challenge in Nigeria, where diagnostic accuracy is essential for effective treatment and management. This systematic review and meta-analysis aimed to compare the diagnostic performance of malaria rapid diagnostic tests (RDTs) with that of microscopy, the gold standard for malaria diagnosis, in Nigeria.  \nMethods A systematic search of Medline (PubMed), Scopus, Web of Science, and Google Scholar and other manually searched articles yielded 502 records. After removing duplicates and screening, 15 studies met the inclusion criteria for the meta-analysis. The risk of bias and applicability were assessed via QUADAS-2 . A random effects model was used to pool sensitivity, specificity, positive and negative likelihood ratios (LR + , LR–), diagnostic odds ratios (DORs), and summary receiver operating characteristic (SROC) curves, with analysis conducted via Meta-Disc 1.4 and the metafor package (version 4 . 6–0) in R (version 4 .4. 1) . Publication bias was assessed via funnel plots and Egger’s test. Leave-one-out sensitivity analyses were conducted to assess the robustness of pooled estimates.  \nResults The pooled sensitivity of RDTs was 69. 7%[95% confidence interval (CI)]: 67 .7–71. 6%, and the specificity was 81. 5%(95% CI 79.9–83. 1%) . The DOR was 21.87 (95% CI 7.45–64. 21) . The SROC curve was 0. 902, though heterogeneity was high (I2 = 96 . 8%) . Subgroup analysis showed regional variability, with better performance in urban settings. Funnel plot asymmetry and Egger’s test suggested publication bias. Leave-one-out analyses confirmed robustness, with pooled estimates ranging 68–75% for sensitivity, 88–91% for specificity, and 17.7–27. 6 for DOR.  \nConclusion Malaria RDTs in Nigeria show suboptimal sensitivity and specificity compared with WHO benchmarks. While RDTs remain the most practical frontline tool due to their accessibility and ease of use, their limitations highlight the need for strengthened diagnostic algorithms that integrate RDTs with microscopy or molecular methods where feasible. Leave-one-out sensitivity analyses confirmed the robustness of the pooled estimates, reinforcing the validity of the conclusions. Advancing RDT technology, improving microscopy practices, and ensuring consistent study reporting are essential to enhance malaria diagnosis and control efforts.  \n*Correspondence:  \nAminu Usman [usman.aminu@umyu.edu.ng](usman.aminu@umyu.edu.ng)[ ](usman.aminu@umyu.edu.ng)Murtala Bindawa Isah[isah. murtala@umyu.edu.ng](isah. murtala@umyu.edu.ng)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence an","cbCaioD7fOrDWror","https://ap.wps.com/l/cbCaioD7fOrDWror","pdf",3008528,13,22,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Keywords\n# Background","[{\"question\":\"What was the main objective of the systematic review and meta-analysis?\",\"answer\":\"To compare the diagnostic performance of malaria rapid diagnostic tests (RDTs) with microscopy, regarded as the gold standard, for malaria diagnosis in Nigeria.\"},{\"question\":\"Which studies and databases were used to identify eligible evidence?\",\"answer\":\"A systematic search of Medline (PubMed), Scopus, Web of Science, and Google Scholar plus other manually searched articles yielded 502 records, and 15 studies met inclusion criteria for the meta-analysis.\"},{\"question\":\"What were the pooled diagnostic performance results for RDTs?\",\"answer\":\"RDTs had pooled sensitivity of 69.7% and specificity of 81.5%, with a DOR of 21.87 and an SROC curve area of 0.902; heterogeneity was high (I2=96.8%).\"},{\"question\":\"What did the review conclude about using RDTs in Nigeria?\",\"answer\":\"RDTs showed suboptimal sensitivity and specificity compared with WHO benchmarks; despite being practical for frontline use, limitations support strengthening diagnostic algorithms by integrating RDTs with microscopy or molecular methods when feasible.\"}]","Performance of rapid diagnostic tests for malaria diagnosis in Nigeria - a systematic review and meta-analysis | PDF",1790757578,55]