Testing the sensitivity and specificity of the fluorescence microscope (Cyscope®) for malaria diagnosis

Background: Early diagnosis and treatment of malaria are necessary components in the control of malaria. The gold standard light microscopy technique has high sensitivity, but is a relatively time-consuming procedure especially during epidemics and in areas of high endemicity. This study attempted to test the sensitivity and specificity of a new diagnostic tool - the Cyscope((R)) fluorescence microscope, which is based on the use of Plasmodium nucleic acid-specific fluorescent dyes to facilitate detection of the parasites even in low parasitaemia conditions due to the contrast with the background. Methods: In this study, 293 febrile patients above the age of 18 years attending the malaria treatment centre in Sinnar State ( Sudan) were interviewed using a structured questionnaire. Finger-prick blood samples were also collected from the participants to be tested for malaria using the hospital's microscope, the reference laboratory microscope, as well as the Cyscope((R)) microscope. The results of the investigations were then used to calculate the sensitivity, specificity, and positive and negative predictive values of the Cyscope((R)) microscope in reference to gold standard light microscopy. Results: The sensitivity was found to be 98.2% ( 95% CI: 90.6% - 100%); specificity = 98.3% ( 95% CI: 95.7% - 99.5%); positive predictive value = 93.3% ( 95% CI: 83.8% - 98.2%); and negative predictive value = 99.6% (95% CI: 97.6% - 100%). Conclusions: In conclusion, the Cyscope((R)) microscope was found to be sensitive, specific and provide rapid, reliable results in a matter of less than 10 minutes. The Cyscope((R)) microscope should be considered as a viable, cheaper and time-saving option for malaria diagnosis, especially in areas where Plasmodium falciparum is the predominant parasite.