Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.

Novel automated digital malaria diagnostic tests are being developed with the advancement of diagnostic tools. Whilst these tools are being evaluated and implemented in the general population, there is the need to focus on special populations such as individuals with Sickle Cell Disease (SCD) who ha...

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Main Authors: Deborah Nimako Sarpong Obeng, Samuel Osei, Nii Kpakpo Brown, David Nana Adjei, Linda Eva Amoah, Ewurama Dedea Ampadu Owusu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-06-01
Series:PLOS Digital Health
Online Access:https://doi.org/10.1371/journal.pdig.0000884
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author Deborah Nimako Sarpong Obeng
Samuel Osei
Nii Kpakpo Brown
David Nana Adjei
Linda Eva Amoah
Ewurama Dedea Ampadu Owusu
author_facet Deborah Nimako Sarpong Obeng
Samuel Osei
Nii Kpakpo Brown
David Nana Adjei
Linda Eva Amoah
Ewurama Dedea Ampadu Owusu
author_sort Deborah Nimako Sarpong Obeng
collection DOAJ
description Novel automated digital malaria diagnostic tests are being developed with the advancement of diagnostic tools. Whilst these tools are being evaluated and implemented in the general population, there is the need to focus on special populations such as individuals with Sickle Cell Disease (SCD) who have altered red blood cell morphology and atypical immune responses, which can obscure parasite detection. This study aimed to evaluate the diagnostic performance of one of such tools, the National Library of Medicine (NLM) malaria screener app in people living with sickle cell disease in a malaria-endemic country, Ghana. A descriptive cross-sectional study was conducted among SCD patients attending the Sickle Cell Clinic at Korle Bu Teaching Hospital in Accra, Ghana. Following informed consent, whole blood samples were collected and analyzed using the NLM malaria screener app, conventional microscopy, RDT, and Polymerase Chain Reaction (PCR), with PCR as the reference standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each diagnostic method were compared against PCR results. The NLM app identified the highest number of positive malaria cases, with 110 positive cases (36.2%), while both RDT and microscopy reported the highest number of negatives, with 287 negative cases (94.4%). Compared to PCR, the NLM app demonstrated a sensitivity of 89.5% and a specificity of 67.4%. RDT and microscopy displayed the same sensitivity as the NLM app, each achieving 89.5%. However, while RDT and microscopy had a specificity of 100%, the NLM app had a considerably lower specificity of 67.4%.The NLM malaria screener app shows promise as a preliminary screening tool for malaria in individuals with SCD. However, its lower specificity indicates a need for confirmatory testing to avoid potential overdiagnosis and mismanagement. Enhancements in the app's specificity could further support its utility in rapid and accessible malaria diagnosis for people with SCD, aiding in timely management and treatment.
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spelling doaj-art-4529dc282e0d47e89dcb3ce2dd2688582025-08-20T03:20:30ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702025-06-0146e000088410.1371/journal.pdig.0000884Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.Deborah Nimako Sarpong ObengSamuel OseiNii Kpakpo BrownDavid Nana AdjeiLinda Eva AmoahEwurama Dedea Ampadu OwusuNovel automated digital malaria diagnostic tests are being developed with the advancement of diagnostic tools. Whilst these tools are being evaluated and implemented in the general population, there is the need to focus on special populations such as individuals with Sickle Cell Disease (SCD) who have altered red blood cell morphology and atypical immune responses, which can obscure parasite detection. This study aimed to evaluate the diagnostic performance of one of such tools, the National Library of Medicine (NLM) malaria screener app in people living with sickle cell disease in a malaria-endemic country, Ghana. A descriptive cross-sectional study was conducted among SCD patients attending the Sickle Cell Clinic at Korle Bu Teaching Hospital in Accra, Ghana. Following informed consent, whole blood samples were collected and analyzed using the NLM malaria screener app, conventional microscopy, RDT, and Polymerase Chain Reaction (PCR), with PCR as the reference standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each diagnostic method were compared against PCR results. The NLM app identified the highest number of positive malaria cases, with 110 positive cases (36.2%), while both RDT and microscopy reported the highest number of negatives, with 287 negative cases (94.4%). Compared to PCR, the NLM app demonstrated a sensitivity of 89.5% and a specificity of 67.4%. RDT and microscopy displayed the same sensitivity as the NLM app, each achieving 89.5%. However, while RDT and microscopy had a specificity of 100%, the NLM app had a considerably lower specificity of 67.4%.The NLM malaria screener app shows promise as a preliminary screening tool for malaria in individuals with SCD. However, its lower specificity indicates a need for confirmatory testing to avoid potential overdiagnosis and mismanagement. Enhancements in the app's specificity could further support its utility in rapid and accessible malaria diagnosis for people with SCD, aiding in timely management and treatment.https://doi.org/10.1371/journal.pdig.0000884
spellingShingle Deborah Nimako Sarpong Obeng
Samuel Osei
Nii Kpakpo Brown
David Nana Adjei
Linda Eva Amoah
Ewurama Dedea Ampadu Owusu
Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
PLOS Digital Health
title Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
title_full Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
title_fullStr Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
title_full_unstemmed Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
title_short Performance of a smartphone-based malaria screener in detecting malaria in people living with Sickle cell disease.
title_sort performance of a smartphone based malaria screener in detecting malaria in people living with sickle cell disease
url https://doi.org/10.1371/journal.pdig.0000884
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