Evaluating the Accuracy of Venous and Capillary Blood Collection in Malaria Di agnosis in Children 0-2year Post Administration Sulfadoxine and Pyrimethamine in Selected Hospitals in the Metropolitan District of Sierra Leone
Abstract:
Introduction: Malaria remains a major public health challenge in Sierra Leone, particularly among children under five, with those aged 0–2 years most vulnerable due to immature immune systems. Preventive interven tions, such as Sulfadoxine–Pyrimethamine (SP), have reduced malaria incidence and severity, yet accurate diagnosis remains critical. Malaria can be detected using microscopy, rapid diagnostic tests, or molecular methods, but result accuracy depends on blood sample quality. Venous collection provides larger volumes but is more invasive, while capillary sampling is quicker and less distressing for children. This study evaluates the accuracy of venous and capillary blood for malaria diagnosis post-SP administration, aiming to inform optimal pediatric practices.
Method: This comparative cross-sectional study was conducted from July to November 2024 in children aged 0–2 years at three selected hospitals (Ola During Children Hospital, King Harman Maternal and Child Health Hospital, and Rokupa Government Hospital) in Sierra Leone. A total of 150 children post-Sulfadoxine-Pyri methamine administration were enrolled using purposive sampling. Blood samples were collected via venous and capillary methods for malaria diagnosis using RDTs and microscopy. Clinical assessments, parasite den sity counts, and demographic data were recorded. Ethical approval was obtained from the Sierra Leone Ethics Board.
Results: The maximum capillary parasite density was 450,000, while the venous parasite density was 100,000. Capillary samples therefore had significantly higher maximum recorded density than venous samples. The mean density of venous parasites was 9,988.83, whereas the capillary parasite density was 24,353.22; com pared to venous samples, the average parasite density in capillary samples was more than double. The stan dard deviation of venous parasite density was 19,031.034, while that of capillary parasites was 65,530.911.
Conclusion: This study evaluated the accuracy of venous and capillary blood collection methods for malaria diagnosis and found that capillary samples consistently showed higher parasite densities compared to venous samples.
