Comparative evaluation of malaria prevalence using light microscopy and quantitative PCR in selected health centers of southern province, Rwanda.

Abstract

Background: Rwanda is one of the sub-Saharan African countries where malaria remains endemic. Over the past decade, the country experienced a sharp increase in malaria incidence, from 48 cases per 1,000 population in 2012 to 403 cases per 1,000 in 2018. Despite this trend, there is limited literature on the distribution of Plasmodium species in Rwanda. This study assessed the prevalence of Plasmodium species among malaria-positive patients in two health centers, Byimana and Rwaniro, in Southern Rwanda. Methodology: A total of 508 participants were screened using light microscopy and q RT-PCR using the RealStar® Malaria Screen & Type PCR Kit 1.0. The detection rates and species distribution were compared across both diagnostic methods. Results: Of the 508 samples analyzed, q RT PCR detected malaria in 114 participants (22%), while light microscopy identified 94 positive cases (19%). PCR-based species identification revealed P. falciparum in 97 cases (85.09%), followed by P. malariae in 15 cases (13.16%), P. vivax in 7 cases (6.14%), and P. ovale in 6 cases (5.26%). Light microscopy identified P. falciparum in 91 of the 94 positive cases (96.8%) and P. malariae in 4 cases (4.26%). No cases of P. vivax or P. ovale were detected by microscopy. Conclusion: This study provides updated insights into the distribution of Plasmodium species in Southern Rwanda. P. falciparum remains the predominant species across both diagnostic methods. However, the higher detection rate and broader species coverage by q RT PCR highlight the limitations of microscopy alone and support the integration of molecular tools for more accurate malaria diagnosis and surveillance.