Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods
Introduction. Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective. This study aimed to evaluate clinical examination reliability compared with...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Journal of Tropical Medicine |
| Online Access: | http://dx.doi.org/10.1155/2022/5883173 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849402995636174848 |
|---|---|
| author | Neguemadji Ngardig Ngaba Imteyaz A. Khan Namrata Hange Maria kezia Lourdes Ligsay Pormento Manoj Kumar Reddy Somagutta Ajay Kumar Youssouf Abdelkerim Alarangue Djindimadje Samia Jahan |
| author_facet | Neguemadji Ngardig Ngaba Imteyaz A. Khan Namrata Hange Maria kezia Lourdes Ligsay Pormento Manoj Kumar Reddy Somagutta Ajay Kumar Youssouf Abdelkerim Alarangue Djindimadje Samia Jahan |
| author_sort | Neguemadji Ngardig Ngaba |
| collection | DOAJ |
| description | Introduction. Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective. This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods. The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results. Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/μL. The threshold pyrogen of the parasitic density was around 10.000 parasites/μL for patients between 0 and 11 months of age, between 1 and 4 years of age, and between 5 and 14 years of age. This threshold was lower for patients over 15 years of age. The study reported some issues in the findings: 60.88% (607/997) cases of fever without positivity of the blood thick smear and 40.13% (284/674) cases of positivity of the thick drop without fever. The positive predictive value of malaria was between 80 and 85% for patients under 5 years of age. This value is lower for patients between 5 and 14 years of age and patients over 15 years of age. Conclusion. A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered. |
| format | Article |
| id | doaj-art-92e985f67b4c4d4c829c7ac0a05a8e88 |
| institution | Kabale University |
| issn | 1687-9694 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Tropical Medicine |
| spelling | doaj-art-92e985f67b4c4d4c829c7ac0a05a8e882025-08-20T03:37:23ZengWileyJournal of Tropical Medicine1687-96942022-01-01202210.1155/2022/5883173Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional MethodsNeguemadji Ngardig Ngaba0Imteyaz A. Khan1Namrata Hange2Maria kezia Lourdes Ligsay Pormento3Manoj Kumar Reddy Somagutta4Ajay Kumar5Youssouf Abdelkerim6Alarangue Djindimadje7Samia Jahan8CHU Bon Samaritain de WaliaRugers Robert Wood Johnson Medical SchoolEurasian Cancer Research CouncilAteneo de Manila University School of Medicine and Public HealthAvalon University School of MedicineMedstar Union Memorial HospitalCHU Bon Samaritain de WaliaCHU Bon Samaritain de WaliaDhaka Medical CollegeIntroduction. Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective. This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods. The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results. Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/μL. The threshold pyrogen of the parasitic density was around 10.000 parasites/μL for patients between 0 and 11 months of age, between 1 and 4 years of age, and between 5 and 14 years of age. This threshold was lower for patients over 15 years of age. The study reported some issues in the findings: 60.88% (607/997) cases of fever without positivity of the blood thick smear and 40.13% (284/674) cases of positivity of the thick drop without fever. The positive predictive value of malaria was between 80 and 85% for patients under 5 years of age. This value is lower for patients between 5 and 14 years of age and patients over 15 years of age. Conclusion. A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered.http://dx.doi.org/10.1155/2022/5883173 |
| spellingShingle | Neguemadji Ngardig Ngaba Imteyaz A. Khan Namrata Hange Maria kezia Lourdes Ligsay Pormento Manoj Kumar Reddy Somagutta Ajay Kumar Youssouf Abdelkerim Alarangue Djindimadje Samia Jahan Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods Journal of Tropical Medicine |
| title | Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods |
| title_full | Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods |
| title_fullStr | Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods |
| title_full_unstemmed | Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods |
| title_short | Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods |
| title_sort | rationalization of the laboratory diagnosis for good management of malaria lessons from transitional methods |
| url | http://dx.doi.org/10.1155/2022/5883173 |
| work_keys_str_mv | AT neguemadjingardigngaba rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT imteyazakhan rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT namratahange rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT mariakezialourdesligsaypormento rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT manojkumarreddysomagutta rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT ajaykumar rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT youssoufabdelkerim rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT alaranguedjindimadje rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods AT samiajahan rationalizationofthelaboratorydiagnosisforgoodmanagementofmalarialessonsfromtransitionalmethods |