scholarly journals Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Andria Rusk ◽  
Catherine Goodman ◽  
Violet Naanyu ◽  
Beatrice Koech ◽  
Andrew Obala ◽  
...  

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance.

2021 ◽  
Author(s):  
Sindew M. Feleke ◽  
Emily N. Reichert ◽  
Hussein Mohammed ◽  
Bokretsion G. Brhane ◽  
Kalkidan Mekete ◽  
...  

AbstractMalaria diagnostic testing in Africa is threatened by Plasmodium falciparum parasites lacking histidine-rich protein 2 (pfhrp2) and 3 (pfhrp3) genes. Among 12,572 subjects enrolled along Ethiopia’s borders with Eritrea, Sudan, and South Sudan and using multiple assays, we estimate HRP2-based rapid diagnostic tests would miss 9.7% (95% CI 8.5-11.1) of falciparum malaria cases due to pfhrp2 deletion. Established and novel genomic tools reveal distinct subtelomeric deletion patterns, well-established pfhrp3 deletions, and recent expansion of pfhrp2 deletion. Current diagnostic strategies need to be urgently reconsidered in Ethiopia, and expanded surveillance is needed throughout the Horn of Africa.


2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Maya Beganovic ◽  
Tristan T Timbrook ◽  
Sarah M Wieczorkiewicz

Abstract Antimicrobial stewardship (AMS) programs integrated with rapid diagnostic tests optimize patient outcomes and reduce time to effective therapy (TTET) and time to optimal therapy (TTOT). This study identifies predictors of TTET and TTOT among patients with positive blood cultures and identifies limitations to current TTOT definitions and outcomes.


2015 ◽  
Vol 9 (03) ◽  
pp. 321-324 ◽  
Author(s):  
Lurdes Santos ◽  
Nuno Rocha Pereira ◽  
Paulo Andrade ◽  
Paulo Figueiredo Dias ◽  
Carlos Lima Alves ◽  
...  

Malaria diagnosis remains a concern in non-endemic countries, with rapid diagnosis being crucial to improve patients’ outcome. Rapid diagnostic tests have high sensitivity but they also have flaws and false-negative results that might jeopardize malaria diagnosis. Some false-negative results might relate to a prozone-like effect. The authors describe two patients with false-negative rapid diagnostic tests in which a prozone-like effect might have been involved. The authors highlight that these tests should not be used without accompanying light microscopy observation of blood films and discuss potential benefits of using rapid diagnostic tests with more than one specific antigen for Plasmodium falciparum.


2013 ◽  
Vol 12 (1) ◽  
pp. 73 ◽  
Author(s):  
Juan Yan ◽  
Nana Li ◽  
Xu Wei ◽  
Peipei Li ◽  
Zhenjun Zhao ◽  
...  

Author(s):  
Pratima Gupta ◽  
Priyanka Gupta ◽  
Shalinee Rao ◽  
Neha Singh ◽  
Deepjyoti Kalita

 Objectives: Malaria is one of the most prevalent parasitic diseases all over the world including India. Although the microscopic study of stained peripheral blood smear (PBS) is a gold standard of malaria diagnosis due to some subjective errors, rapid diagnostic tests (RDTs) can be a suitable alternative. This study was conducted to estimate the prevalence and demographic details of malaria cases along with a comparison between the two most common screening methods: PBS and RDTs.Methods: Demographic profile, the prevalence of malaria in this region of Uttarakhand and evaluation of efficacy of RDT as a screening method was performed. Analysis of PBS microscopy for malaria parasites was performed and compared with immunochromatography based RDT over a duration of 3 years.Results: Out of total 2982 clinically suspected patients of malaria, 132 were found to be positive by either of the two methods. Prevalence of malaria was 4.4% in our study. Plasmodium vivax was the predominant species isolated (95%). Males outnumbered females with a ratio of 2.1:1. The most common age group affected was 30–49 years. Sensitivity and specificity of RDT was found to be 91.8% and 93.8%, respectively. Positive predictive value and negative predictive value were found to be 97.8% and 98.9%, respectively.Conclusion: We conclude that Uttarakhand is a low prevalence area for Malaria and the RDT based on malaria antigen (whole blood) method is as specific and sensitive as the traditional PBS microscopy. Thus, it can be used as an alternative to PBS microscopy.


2019 ◽  
Vol 113 (11) ◽  
pp. 701-705 ◽  
Author(s):  
Zakya A Abdalla ◽  
NourElhouda A Rahma ◽  
Elhashimi E Hassan ◽  
Tajeldin M Abdallah ◽  
Hadeel E Hamad ◽  
...  

Abstract Background Accurate diagnosis of malaria infection is essential for successful control and management of the disease. Both microscopy and rapid diagnostic tests (RDTs) are recommended for malaria diagnosis, however, RDTs are more commonly used. The aim of the current study was to assess the performance of microscopy and RDTs in the diagnosis of Plasmodium falciparum infection using a nested polymerase chain reaction (PCR) assay as the gold standard. Methods A cross-sectional study was carried out in Kassala Hospital, eastern Sudan. A total of 341 febrile participants of all ages were recruited. Blood specimens were collected and malaria testing was performed using an RDT (SD Bioline Malaria Ag Pf), microscopy and nested PCR. The sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) of microscopy and the RDT were investigated. Results The prevalence of P. falciparum malaria infections in this study was 22.9%, 24.3% and 26.7% by PCR, microscopy and RDT, respectively. Compared with microscopy, the RDT had slightly higher sensitivity (80.7% vs 74.3%; p=0.442), equivalent specificity (89.3% vs 90.4%), a similar PPV (69.2% vs 69.8%) and a higher NPV (94.0% vs 92.2%). Conclusions The diagnostic performance of the RDT was better than that of microscopy in the diagnosis of P. falciparum malaria when nested PCR was used as the gold standard.


2002 ◽  
Vol 15 (1) ◽  
pp. 66-78 ◽  
Author(s):  
Anthony Moody

SUMMARY Malaria presents a diagnostic challenge to laboratories in most countries. Endemic malaria, population movements, and travelers all contribute to presenting the laboratory with diagnostic problems for which it may have little expertise available. Drug resistance and genetic variation has altered many accepted morphological appearances of malaria species, and new technology has given an opportunity to review available procedures. Concurrently the World Health Organization has opened a dialogue with scientists, clinicians, and manufacturers on the realistic possibilities for developing accurate, sensitive, and cost-effective rapid diagnostic tests for malaria, capable of detecting 100 parasites/μl from all species and with a semiquantitative measurement for monitoring successful drug treatment. New technology has to be compared with an accepted Rgold standardS that makes comparisons of sensitivity and specificity between different methods. The majority of malaria is found in countries where cost-effectiveness is an important factor and ease of performance and training is a major consideration. Most new technology for malaria diagnosis incorporates immunochromatographic capture procedures, with conjugated monoclonal antibodies providing the indicator of infection. Preferred targeted antigens are those which are abundant in all asexual and sexual stages of the parasite and are currently centered on detection of HRP-2 from Plasmodium falciparum and parasite-specific lactate dehydrogenase or Plasmodium aldolase from the parasite glycolytic pathway found in all species. Clinical studies allow effective comparisons between different formats, and the reality of nonmicroscopic diagnoses of malaria is considered.


2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Stuart D. Blacksell

Dengue fever, dengue haemorrhagic fever, and dengue shock syndrome (DF/DHF/DSS) are tropical diseases that cause significant humanitarian and economic hardship. It is estimated that more than 2.5 billion people are at risk of infection and more than 100 countries have endemic dengue virus transmission. Laboratory tests are essential to provide an accurate diagnosis of dengue virus infection so that appropriate treatment and patient management may be administered. In many dengue endemic settings, laboratory diagnostic resources are limited and simple rapid diagnostic tests (RDTs) provide opportunities for point-of-care diagnosis. This paper addresses current issues relating to the application of commercial dengue RDTs for the diagnosis of acute dengue virus infection, recent diagnostic evaluations, and identifies future needs.


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