Accuracy of Malaria Diagnosis by Microscopy, Rapid Diagnostic Test, and PCR Methods and Evidence of Antimalarial Overprescription in Non-Severe Febrile Patients in Two Tanzanian Hospitals

Nicastri, Emanuele; Bevilacqua, Nazario; Schepisi, Monica Sañé; Paglia, Maria Grazia; Meschi, Silvia; Shaali, M.; Mohamed, Jape A.; Mangi, Sabina; Fumakule, R.; Di, Antonino; Capobianchi, Maria Rosaria; Kitua, Andrew Y; Molteni, Fabrizio; Racalbuto, Vincenzo; Ippolito, Giuseppe

doi:10.4269/ajtmh.2009.80.712

Cited by 68 publications

(55 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This implies a significant overuse of ACT in the community as previously reported in another study in Tanzania (Nicastri et al, 2009). This irrational use of antimalarials puts further pressure on constrained resources and may promote development of malaria drug resistance.…”

Section: Discussionmentioning

confidence: 48%

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Mwanziva

Manjurano

Mbugi

et al. 2011

Tanzania J Hlth Res

View full text Add to dashboard Cite

Malaria morbidity and mortality data from clinical records provide essential information towards defining disease burden in the area and for planning control strategies, but should be augmented with data on transmission intensity and serological data as measures for exposure to malaria. The objective of this study was to estimate the malaria burden based on serological data and prevalence of malaria, and compare it with existing self-treatment practices in Magugu in Babati District of northern Tanzania. Prospectively, 470 individuals were selected for the study. Both microscopy and Rapid Diagnostic Test (RDT) were used for malaria diagnosis. Seroprevalence of antibodies to merozoite surface proteins (MSP-119) and apical membrane antigen (AMA-1) was performed and the entomological inoculation rate (EIR) was estimated. To complement this information, retrospective data on treatment history, prescriptions by physicians and use of bed nets were collected. Malaria prevalence in the area was 6.8% (32/470). Of 130 individuals treated with artemisinin combination therapy (ACT), 22.3 % (29/130) were slide confirmed while 75.3% (98/130) of them were blood smear negative. Three of the slides confirmed individuals were not treated with ACT. Fever was reported in 38.2% of individuals, of whom 48.8 % (88/180) were given ACT. Forty-two (32.3%) of those who received ACT had no history of fever. About half (51.1%) of those treated with ACT were children <10 years old. Immunoglobulin against MSP-119 was positive in 16.9% (74/437) while against AMA-1 was positive in 29.8 % (130/436). Transmission intensity was estimated at <0.2 infectious bites per person per year. The RDT was highly specific (96.3%) but with low sensitivity (15.6%). In conclusion, Magugu is a low endemic area. There is substantial over diagnosis, over treatment and self treatment in the community. The burden of malaria based on medical records is over estimated as was mostly presumptive. The low sensitivity of RDT reflects the low number of immune individuals as well as the low parasite density. ________________________________________________________________________________

show abstract

Section: Discussionmentioning

confidence: 48%

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Mwanziva

Manjurano

Mbugi

et al. 2011

Tanzania J Hlth Res

View full text Add to dashboard Cite

show abstract

“…Parasitol., 10 (3): 120-126, 2015 The sensitivity of RDT reported in this study is lower than previous reports in Nigeria (Ajumobi et al, 2015) and other parts of the world. Sensitivities of 96, 97 and 97.6% had been reported in Zambia, Zanzibar and Thailand, respectively (Hopkins et al, 2008;Msellem et al, 2009;Nicastri et al, 2009). However, the specificity 87% is similar to 88% reported by Msellem et al (2009) but lower than 93 and 100% recorded in Thailand (Buchachart et al, 2004) and among Nigerian travellers (Dougnon et al, 2015).…”

Section: Discussionmentioning

confidence: 67%

Comparative Assessment of Microscopy and Rapid Diagnostic Test (RDT) as Malaria Diagnostic Tools

Oyeyemi¹,

Ogunlade²,

Oyewole³

2015

Research J. of Parasitology

View full text Add to dashboard Cite

Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The aim of this study was to compare the effectiveness of RDT and microscopy in detection of malaria parasite in a malaria endemic area of Nigeria among different population groups. The cross sectional study was conducted on 251 febrile patients who were directed to the laboratory department for blood screening for malaria parasites at Ogunlade Hospital, Ijebu Ode, Ogun state. Blood samples were collected and screened for malaria parasites microscopically and by using First Response RDT. The prevalence of malaria obtained through microscopy (66.8%) was significantly higher than in RDT (36.8%) (p<0.05). Considering microscopy as the gold standard, RDT exhibited high specificity (87.1%) and low sensitivity (42.5%) with positive predictive and negative predictive values of 86.6 and 43.5%, respectively. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia (p<0.0001). The routine microscopy test demonstrated a superior sensitivity compared to First Response RDT method of malaria diagnosis, however, RDT could be a useful tool in individuals suspected to show high degree of disease spectrum for quick intervention in order to avert danger associated with delayed diagnosis.

show abstract

“…14 The KCH laboratory conducted more than 240,000 laboratory tests in 2010. The most common tests requested were malaria (66,601), full blood count (FBC) (32,909), and CD4 counts (13,947). 15 Study design and methods.…”

Section: Methodsmentioning

confidence: 99%

“…Audio recordings of interviews were transcribed into Microsoft Word, and a codebook was constructed using the editing method described by Crabtree and Miller. 13 As part of this process, two of the authors developed independent codebooks, then harmonized them into a single codebook through an adjudication process. Each code was given a definition that corresponded with the challenge or theme it highlighted.…”

Section: Methodsmentioning

confidence: 99%

“…Rather, the literature on laboratory challenges in low-resource settings focuses on disease-specific laboratory processes and interventions, such as microscopy for malaria, often addressing generalizable testing issues only in the context of a specific disease. [10][11][12][13] Understanding workflow barriers, perceptions of challenges, and the interactions between the laboratory and providers in low-resource settings is an important step to improving the use of laboratory testing across all conditions and diseases. This study aims to gain a more granular understanding of the specific challenges encountered in laboratory testing in a low-resource setting hospital laboratory, specifically the laboratory at Kamuzu Central Hospital (KCH), Malawi, as perceived by healthcare providers engaged in the diagnostic process.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing Perceived Challenges to Laboratory Testing at a Malawian Referral Hospital

Petrose

Fisher

Douglas

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Adequate laboratory infrastructure in sub-Saharan Africa is vital for tackling the burden of infectious diseases such as human immunodeficiency virus and acquired immune deficiency syndrome, malaria, and tuberculosis, yet laboratories are ill-integrated into the diagnostic and care delivery process in low-resource settings. Although much of the literature focuses on disease-specific challenges around laboratory testing, we sought to identify horizontal challenges to the laboratory testing process through interviews with clinicians involved in the diagnostic process. Based on 22 interviews with physicians, nurses, clinical officers, medical students, and laboratory technicians, technologists and supervisors, we identified 12 distinct challenges in the areas of staff, materials, workflow, and the blood bank. These challenges underscore the informational challenges that compound more visible resource shortages in the laboratory testing process, which lend themselves to horizontal strengthening efforts around the diagnostic process.

show abstract

Accuracy of Malaria Diagnosis by Microscopy, Rapid Diagnostic Test, and PCR Methods and Evidence of Antimalarial Overprescription in Non-Severe Febrile Patients in Two Tanzanian Hospitals

Cited by 68 publications

References 17 publications

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Comparative Assessment of Microscopy and Rapid Diagnostic Test (RDT) as Malaria Diagnostic Tools

Assessing Perceived Challenges to Laboratory Testing at a Malawian Referral Hospital

Contact Info

Product

Resources

About