Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India

Vyas, Sonal; Puwar, B.; Patel, Vaishali; Bhatt, Ganesh; Kulkarni, S.; Fancy, M.

doi:10.26719/2014.20.4.236

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…These observations corroborate with those from other studies which report the well-known limitation of tests performances with low parasitaemia and false negative results with parasite densities above 500 parasites/ µL [5,[18][19][20]. Although the inability of RDTs to detect some high parasitaemia is a rare event, it is not parasite species or antigen specific and it was previously reported by others [4,5,[18][19][20][21]. The prozone effect and the deletion of the histidine rich repeat region might explain such negative result with high parasitaemia [14,14,22].…”

Section: Discussionsupporting

confidence: 91%

“…Although the prevalence rate of non-falciparum malaria is low in the study population, this result should be taken into account. Non negligible frequencies of P. falciparum-non falciparum mixed infections or single non-falciparum malaria infections misclassifications were recorded with single or comboRDTs evaluated within the country and in other settings [18,29]. The main limitation of this study is that molecular DNA amplification that displays higher Se for low parasitaemia detection and thereby reduces the frequency of FP results was not used as gold standard.…”

Section: Discussionmentioning

confidence: 93%

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Performances of SD Bioline Malaria Ag-P.F/Pan RDT for the Diagnosis of Malaria in Febrile Patients Living In Gabon, Central Africa

MK¹

2014

Malaria Contr Elimination

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The SD Bioline malaria Ag-Pf/Pan performances were evaluated for malaria species detection in 215 febrile patients living in Gabon, using microscopy as gold standard. Malaria parasites were identified in 94 (43.7%) individuals by microscopy, and 104 (48.4%) patients tested positive by the RDT. The SD Bioline Ag-Pf/Pan global sensitivity was 96.8%. All the non-falciparum malaria species infections were correctly diagnosed by the rapid test. The specificity was of 89.3% and the false positive (FP) rate of 12.5%. The test sensitivity significantly increased with parasitaemia, being of 88.9% for parasite density below 100/ µL and 98.5% at density higher than 500 parasites/ µL (p<0.01). Among the patients with a negative blood smear, the proportion of FP results was 21.0% in those previously-treated with an antimalarial drug before the consultation, and 8.8% in individuals without self-medication. SD Bioline Ag-Pf/ Pan RDT represents a good alternative to microscopy for the diagnosis of Plasmodium spp infection.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

Performances of SD Bioline Malaria Ag-P.F/Pan RDT for the Diagnosis of Malaria in Febrile Patients Living In Gabon, Central Africa

MK¹

2014

Malaria Contr Elimination

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“…The comparability of results of both microcopy and some RDT kits [ 32 - 34 ] has been assessed and RDTs have been found to be acceptable to caregivers in rural Ghana [ 4 ], communities in Uganda [ 35 ] and among health workers in Uganda. The sensitivity and specificity of some RDTs have been well documented [ 36 ] and their specificity, sensitivity and acceptability as an alternative to microcopy established in a study in India [ 37 ]. RDTs have been found to improve malaria diagnosis in low level health care facilities in Uganda [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions

Febir

Baiden

Agula

et al. 2015

Malar J

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BackgroundTimely and appropriate management of febrile illness among children under five years of age will contribute to achieving Millennium Development Goal-4. The revised World Health Organization-Global Malaria Programme’s policy on test-based management of malaria must integrate effectively into the Integrated Management of Childhood Illness (IMCI). This study reports on perceptions of health workers on the health system factors influencing effective delivery of test-based diagnosis of malaria with IMCI.MethodsA qualitative study was conducted among a range of health workers at different levels of the health system in the Brong Ahafo Region of Ghana. Interview transcripts were transferred into Nvivo 8 software for data management and analysis. A frame-work approach at two levels was used in the analysis, which included the processes required for implementation of test-based management of malaria and the health systems context.ResultsForty-nine in-depth interviews were conducted. The National Health Insurance Scheme (NHIS) was perceived to have led to an increase in health facility attendance, thereby increasing the workload of health workers. Workload was reported as the main reason that health workers were not able to complete all of the examinations included in the IMCI algorithm. The NHIS financing guidelines were seen to be determining diagnosis and treatment practices by health-care givers. Concern was expressed about the erratic supply of malaria rapid diagnostic test kits (RDTs), the quality of RDTs related to potential false negative results when clinical symptoms were consistent with malaria. IMCI was seen as important but practically impossible to fully implement due to workload.ConclusionsImplementation of the WHO-revised IMCI guideline is confronted with a myriad of health systems challenges. The perceptions of front-line health workers on the accuracy and need for RDTs together with the capacity of health systems to support implementation plays a crucial role. The NHIS financing guidelines of diagnostics and treatments are influencing clinical decision-making in this setting. Further study is needed to understand the impact of the NHIS on the feasibility of integrating test-based management for malaria into the IMCI guidelines.

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“…use of excess buffer/inappropriate sample well, storage-related challenges but they are easily overcome with training and routine supervision. Several recent studies have continued to validate the usefulness and reliability of RDTs for malaria diagnosis in both children and adults [ 19 – 24 ]. The acceptability of RDT among care-seekers attending public healthcare facilities, patent medicine vendors and private health retailers has also been documented by research [ 25 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

Status of the use and compliance with malaria rapid diagnostic tests in formal private health facilities in Nigeria

Mokuolu

Ntadom

Ajumobi

et al. 2016

Malar J

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Background Nigeria has the largest number of malaria-related deaths, accounting for a third of global malaria deaths. It is important that the country attains universal coverage of key malaria interventions, one of which is the policy of universal testing before treatment, which the country has recently adopted. However, there is a dearth of data on its implementation in formal private health facilities, where close to a third of the population seek health care. This study identified the level of use of malaria rapid diagnostic testing (RDT), compliance with test results and associated challenges in the formal private health facilities in Nigeria.Methods A cross-sectional study that involved a multi-stage, random sampling of 240 formal private health facilities from the country’s six geo-political zones was conducted from July to August 2014. Data were collected using health facility records, healthcare workers’ interviews and an exit survey of febrile patients seen at the facilities, in order to determine fever prevalence, level of testing of febrile patience, compliance with test results, and health workers’ perceptions to RDT use.ResultsData from the 201 health facilities analysed indicated a fever prevalence of 38.5 % (112,521/292,430). Of the 2077 exit interviews for febrile patients, malaria testing was ordered in 73.8 % (95 % CI 71.7–75.7 %). Among the 1270 tested, 61.8 % (719/1270) were tested with microscopy and 38.2 % (445/1270) with RDT. Compliance to malaria test result [administering arteminisin-based combination therapy (ACT) to positive patients and withholding ACT from negative patients] was 80.9 % (95 % CI 78.7–83 %). Compliance was not influenced by the age of patients or type of malaria test. The health facilities have various cadres of the health workers knowledgeable on RDT with 70 % knowing the meaning, while 84.5 % knew what it assesses. However, there was clearly a preference for microscopy as only 20 % reported performing only RDT.ConclusionIn formal private health facilities in Nigeria there is a high rate of malaria testing for febrile patients, high level of compliance with test results but relatively low level of RDT utilization. This calls for improved engagement of the formal private health sector with a view to achieving universal coverage targets on malaria testing.

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Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India

Cited by 7 publications

References 8 publications

Performances of SD Bioline Malaria Ag-P.F/Pan RDT for the Diagnosis of Malaria in Febrile Patients Living In Gabon, Central Africa

Performances of SD Bioline Malaria Ag-P.F/Pan RDT for the Diagnosis of Malaria in Febrile Patients Living In Gabon, Central Africa

Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions

Status of the use and compliance with malaria rapid diagnostic tests in formal private health facilities in Nigeria

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