Performance comparison of rapid diagnostic test, microscopy, and polymerase chain reaction for Malaria detection in high-transmission area, Keerom Regency, Papua Province, Indonesia.

This study evaluates the performance of three diagnostic methods for malaria detection, Rapid Diagnostic Tests (RDTs), microscopy, and Polymerase Chain Reaction (PCR), in the high-transmission area of Keerom Regency, Papua Province, Indonesia. With malaria posing a significant health threat, particularly in Indonesia, accurate and timely diagnosis is crucial for effective treatment and disease management. The study involved 234 participants suspected of having uncomplicated malaria, with blood samples analyzed using all three diagnostic methods. Results indicated that PCR identified 42.3 % of malaria cases, while microscopy and RDTs detected 26.5 % and 22.6 %, respectively. Notably, PCR revealed a substantial number of cases missed by microscopy and RDTs, highlighting the limitations of these methods in low-parasitemia situations. The sensitivity and specificity of microscopy and RDTs were assessed against PCR as the reference standard, revealing significant discrepancies in diagnostic accuracy. The findings underscore the need for enhanced diagnostic strategies to improve case detection and support elimination efforts in Keerom regency, Papua, Indonesia.