Performance comparison between Conventional Polymerase Chain Reaction and AbTes Real-time polymerase chain reaction with the gold standard of microscopy imaging detection method

Background: Microscopy imaging-based detection is the main component of the malaria diagnostic test. The healthcare technician's skill and experience will influence the results of the malaria microscopy examination. The polymerase chain reaction (PCR) is another sensitive detection technique that can be used as a diagnostic tool. PCR methods can be based on the conventional method or Real-time PCR. Real-time PCR is said to be more sensitive than the conventional one. This study aimed to compare the performance of Malaria microscopic imaging, Conventional PCR, and Real-time PCR (abTESTMMalaria qPCRII) for detecting Plasmodium in human blood. Methods: This research was a cross-sectional analytical study that successfully generated 150 specimens from November 2018 to June 2019. Blood samples were examined using microscopy imaging detection, RT-PCR, and conventional PCR. Mann-Whitney test was used to analyze the performance of each test, which was significant if p < 0.05. Results: A total of 150 participants were recruited. Ninety-eight subjects were detected positive by microscopic method and then compared to RT-PCR and conventional PCR. Plasmodium vivax dominated the features of the subject in all three tests. The tests show several multiple infections, like double and triple infections, especially when done by RT-PCR (28.6%). Mann-Whitney analysis revealed the significant difference between microscopic detection and Real-Time PCR AbTes in detecting P falciparum (Pf), P vivax, and P malariae (Pm) (p<0.05). PCR Conventional and Real-time AbTes also differed significantly while evaluating Pm. Conclusion: Real-time PCR (abTEST Malaria qPCRII) positivity was beyond microscopic imaging and conventional PCR. It also shows significant differences with another test detecting P falciparum, Plasmodium vivax, and P malariae.