A rapid manual test for Plasmodium falciparum, the ParaSight-F test, has been used on a series of patients in a holoendemic malaria area of coastal Tanzania. The test, which is an antigen capture test detecting trophozoite-derived histidine rich protein-II, is simple to perform and provides a definitive answer in about 10 min. It requires no special equipment and is read using a single drop of blood. When compared with 272 thick blood films examined microscopically by 2 observers and confirmed by the QBC malaria test, the ParaSight-F test had 88.9% sensitivity and 87.5% specificity. Detectable antigenaemia in a group of 40 people declined following treatment with Fansidar and by 10 d after treatment all but 4 individuals were antigen free. The remaining 4, although clear of peripheral parasitaemia, remained antigenaemic for 14 d. The test shows great promise for rapid effective diagnosis of P. falciparum in clinics and village health centres where there is no facility for microscopy. Because of its accuracy and rapid action it may even obviate the need for microscopical examination of blood films to diagnose P. falciparum malaria.

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The mosquito sampling efficiency of CDC miniature light-traps, relative to night-biting collections, was evaluated indoors at two sites in coastal Tanzania. We found that the total number of anophelines captured overnight by light-traps (hung beside a bednet in use) was 1.23 times the number of anophelines captured by human-bait collections. This relationship was not affected significantly by changes in the mosquito density, order of trapping method, date of sampling, or number of household occupants. Malaria sporozoite rates were twice as high among mosquitoes captured by light-trap as compared to those captured by night-biting collection. This was attributed to the tendency of light-traps to capture a larger proportion of gravid mosquitoes, which also had high sporozoite rates. The differences in sporozoites rates according to abdominal stage indicates that unfed mosquitoes captured by light-traps may define more precisely the human-biting activity and sporozoite rates as seen by night-biting collections. Our study shows that light-traps, when used in combination with night-biting collections, can be an effective and sensitive means for measuring human-biting activity and the sporozoite rate.

SummaryPrior to an intervention on improving the quality of malaria case management, we assessed mothers' abilities to recognize nonsevere and severe/complicated malaria in children when a child has fever with other physiological and behavioural symptoms associated with malaria. Malaria was mentioned as the commonest febrile illness (94.1%), convulsions the least (11.4%). Fever and enteric symptoms featured as the most important symptoms of childhood malaria at frequencies of 93.5% and 73.8%, respectively. The need for laboratory diagnosis was very high (98.3%), the reason being to get accurate diagnosis and treatment (89.4%). Poor outcome of treatment was ascribed to incorrect diagnosis and prescription, noncompliance at home and ineffective drugs (62.1%). Most mothers (86.6%) would take antipyretic measures first when a child has fever, and subsequently the majority (92.9%) would seek care at a modern health facility. About 50% of the mothers would give traditional treatments for childhood convulsions and wait till fits cease before the next action. A high proportion of the mothers (75%) held the belief that an injection in a child with high fever would precipitate convulsions or death. The implications of these findings for chemotherapeutic malaria control in holoendemic areas within the context of the Integrated Management of Childhood Illnesses (IMCI) strategy are discussed.keywords childhood illnesses, fever, suspicion index, malaria control,Tanzania correspondence Dr Donath S.Tarimo,

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