Malaria among relatives escorting sick patients during the dry season to Karume Health Centre, Mwanza, Northwestern Tanzania

Abstract

Malaria is still a public health problem in the world. It accounted for an estimated 214 million cases and 438,000 deaths in the year 2015. During the dry season, most people are likely to be asymptomatic and therefore fail to be diagnosed with malaria. This study established the proportion of people who came to health facility, escorting sick relatives and had detectable malaria parasites. This was a cross sectional study. All relatives who escorted sick patients to Karume Health Centre between August and December 2013 were screened for malaria using malaria rapid diagnostic test (mRDT) and single round PCR targeting mitochondrial DNA. A total of 400 relatives were screened for malaria using two methods. Prevalence of malaria was 14.5 and 16.8% by mRDT and polymerase chain reaction (PCR), respectively. The prevalence of malaria was higher among febrile patients by methods, mRDT (17.8%) and PCR (17.1%), respectively. The prevalence of asymptomatic malaria was 16.4 and 16.5% by mRDT and PCR, respectively. The overall agreement between the two tests was 87.1% with positive agreement of 63.8% and negative agreement of 91.2%. There were a substantial proportion of patients with malaria who visited the health facilities during the dry season. mRDT and single round PCR targeting mitochondrial DNA had a good agreement and can be used for detection of both symptomatic and asymptomatic malaria. Provider initiated screening can help to improve malaria detection during the dry season, as we move towards reduced malaria prevalence and elimination phase.