PMID- 27941107
OWN - NLM
STAT- MEDLINE
DCOM- 20180112
LR  - 20190115
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 63
IP  - suppl 5
DP  - 2016 Dec 15
TI  - Malaria Rapid Diagnostic Tests and Malaria Microscopy for Guiding Malaria
      Treatment of Uncomplicated Fevers in Nigeria and Prereferral Cases in 3 African
      Countries.
PG  - S290-S297
AB  - BACKGROUND: The World Health Organization recommends that malaria treatment be
      based on demonstration of the infecting Plasmodium parasite specie. Malaria rapid
      diagnostic tests (RDTs) are recommended at community points of care because they 
      are accurate and rapid. We report on parasitological results in a malaria study
      in selected rural communities in 3 African countries. METHODS: In Nigeria,
      community health workers (CHWs) performed RDTs (SD-Bioline) and thick blood
      smears on all children suspected to have malaria. Malaria RDT-positive children
      able to swallow received artemisinin-based combination therapy (Coartem). In all 
      countries, children unable to take oral drugs received prereferral rectal
      artesunate irrespective of RDT result and were referred to the nearest health
      facility. Thick blood smears and RDTs were usually taken at hospital admission.
      In Nigeria and Burkina Faso, RDT cassettes and blood smears were re-read by an
      experienced investigator at study end. RESULTS: Trained CHWs enrolled 2148
      children in Nigeria. Complete parasitological data of 1860 (86.6%) enrollees were
      analyzed. The mean age of enrollees was 30.4 +/- 15.7 months. The prevalence of
      malaria parasitemia in the study population was 77.8% (1447/1860), 77.6%
      (1439/1855), and 54.1% (862/1593) by RDT performed by CHWs vs an expert clinical 
      research assistant vs microscopy (gold standard), respectively. Geometric mean
      parasite density was 6946/microL (range, 40-436 450/microL). There were 49 cases 
      of RDT false-negative results with a parasite density range of 40-54 059/microL. 
      False-negative RDT results with high parasitemia could be due to non-falciparum
      infection or result from a prozone effect. Sensitivity and specificity of
      SD-Bioline RDT results as read by CHWs were 94.3% and 41.6%, respectively, while 
      the negative and positive predictive values were 86.1% and 65.6%, respectively.
      The level of agreement in RDT reading by the CHWs and experienced research staff 
      was 86.04% and kappa statistic of 0.60. The malaria parasite positivity rate by
      RDT and microscopy among children with danger signs in the 3 countries was 67.9% 
      and 41.8%, respectively. CONCLUSIONS: RDTs are useful in guiding malaria
      management and were successfully used for diagnosis by trained CHWs. However,
      false-negative RDT results were identified and can undermine confidence in
      results and control efforts.
CI  - (c) 2016 World Health Organization; licensee Oxford Journals.
FAU - Falade, Catherine O
AU  - Falade CO
AD  - Department of Pharmacology and Therapeutics.
FAU - Ajayi, IkeOluwapo O
AU  - Ajayi IO
AD  - Department of Epidemiology and Medical Statistics, College of Medicine,
      University of Ibadan, Nigeria.
FAU - Nsungwa-Sabiiti, Jesca
AU  - Nsungwa-Sabiiti J
AD  - Child Health Division, Ministry of Health, Kampala, Uganda.
FAU - Siribie, Mohamadou
AU  - Siribie M
AD  - Groupe de Recherche Action en Sante, Ouagadougou, Burkina Faso.
FAU - Diarra, Amidou
AU  - Diarra A
AD  - Groupe de Recherche Action en Sante, Ouagadougou, Burkina Faso.
FAU - Serme, Luc
AU  - Serme L
AD  - Groupe de Recherche Action en Sante, Ouagadougou, Burkina Faso.
FAU - Afonne, Chinenye
AU  - Afonne C
AD  - Epidemiology and Biostatistics Research Unit, Institute of Advanced Medical
      Research and Training, College of Medicine.
FAU - Yusuf, Oyindamola B
AU  - Yusuf OB
AD  - Department of Epidemiology and Medical Statistics, College of Medicine,
      University of Ibadan, Nigeria.
FAU - Gansane, Zakaria
AU  - Gansane Z
AD  - Groupe de Recherche Action en Sante, Ouagadougou, Burkina Faso.
FAU - Jegede, Ayodele S
AU  - Jegede AS
AD  - Department of Sociology, Faculty of Social Sciences, University of Ibadan,
      Nigeria.
FAU - Singlovic, Jan
AU  - Singlovic J
AD  - UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical 
      Diseases, World Health Organization, Geneva, Switzerland.
FAU - Gomes, Melba
AU  - Gomes M
AD  - UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical 
      Diseases, World Health Organization, Geneva, Switzerland.
LA  - eng
GR  - 001/World Health Organization/International
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases
      Society of America
JID - 9203213
RN  - 0 (Artemisinins)
RN  - 9RMU91N5K2 (artemisinine)
SB  - IM
MH  - Artemisinins/administration & dosage/therapeutic use
MH  - Burkina Faso/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Community Health Workers/statistics & numerical data
MH  - Diagnostic Tests, Routine/*methods
MH  - Drug Therapy, Combination
MH  - Female
MH  - Fever/diagnosis/drug therapy/epidemiology
MH  - Humans
MH  - Infant
MH  - Malaria/*diagnosis/drug therapy/epidemiology
MH  - Male
MH  - Microscopy/*methods
MH  - Nigeria/epidemiology
MH  - Parasitemia/diagnosis/drug therapy/epidemiology
MH  - Uganda/epidemiology
PMC - PMC5146700
OTO - NOTNLM
OT  - ACT
OT  - RDT
OT  - malaria
OT  - microscopy
OT  - parasitemia
EDAT- 2016/12/13 06:00
MHDA- 2018/01/13 06:00
CRDT- 2016/12/13 06:00
PHST- 2016/12/13 06:00 [entrez]
PHST- 2016/12/13 06:00 [pubmed]
PHST- 2018/01/13 06:00 [medline]
AID - ciw628 [pii]
AID - 10.1093/cid/ciw628 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2016 Dec 15;63(suppl 5):S290-S297. doi: 10.1093/cid/ciw628.