Objective: Light microscopy which is a blood-based test is the Gold standard for malaria diagnosis in the clinical settings. The low sensitivity of Microscopy coupled with the challenges associated with blood sampling necessitates exploring alternative methods of identifying malaria cases. The aim of this study was to detect the presence of Plasmodium Lactate Dehydrogenase (pLDH) and Plasmodium falciparum Histidine-Rich Protein 2 (PfHRP2) in the saliva of suspected malaria patients and to compare the diagnostic accuracy of these saliva-borne biomarkers with the results of blood film microscopy using Nested PCR as the reference test.
Results: Malaria prevalence rates of 51 (27.13%), 80(42.55%), 117 (62.23%) and 95 (50.53%) were detected by the Microscopy, saliva pLDH, saliva PfHRP2 and the PCR respectively. The sensitivity of the saliva PfHRP2 ELISA, 78.95% (95% CI, 69.38-86.64%) and saliva pLDH ELISA, 64.21% (95% CI 53.72 -73.79) was better than the blood film Microscopy and showed moderate agreement with results of the Nested PCR with Kappa co-efficient of 0.5 and 0.44 respectively.