scholarly journals A Difficult Diagnosis of Plasmodium ovale Malaria

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Ana Santos-Reis ◽  
Jaime Nina
Keyword(s):  
Training Programs ◽  
Complete Blood Count ◽  
Malaria Diagnosis ◽  
Parasitic Diseases ◽  
Plasmodium Ovale ◽  
Difficult Diagnosis ◽  
Mild Anemia ◽  
Imported Cases ◽  
Tropical Areas ◽  
Malaria Microscopy

Malaria is a major cause of suffering, disease, and death worldwide and is considered the most important of all human parasitic diseases. Malaria is still endemic in most tropical and sub-tropical areas and globalization has contributed to an increase of imported cases around the world. We report a Plasmodium ovale infection in a traveler with recent return from a long land trip across West Africa. He declared adherence to mefloquine chemoprophylaxis only at the start of the trip. Initially, he was seen at two different hospitals and in both he was screened for malaria by microscopy and rapid diagnostic test, but his diagnosis was not confirmed. The traveler was then diagnosed at our hospital with a malaria infection by Plasmodium ovale. Complete blood count showed mild anemia, but leukocytes and platelets were already normal. Symptoms resolved in 24 hours after treatment started. Microscopy of stained blood films remains the gold standard for malaria diagnosis, which is critically dependent on trained eyes. In non-endemic regions with few cases during the year, training programs in malaria microscopy are crucial. The aim is to prevent the reintroduction of malaria in Europe, reduce individual morbidity and suffering, and thus contribute towards reduction in deaths caused by this disease.

scholarly journals Quality of malaria diagnosis and molecular confirmation of Plasmodium ovale curtisi in a rural area of the southeastern region of Ethiopia

2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Pedro Berzosa Díaz ◽  
Patricia Mula Lozano ◽  
Jose Manuel Ramos Rincón ◽  
Luz García ◽  
Francisco Reyes ◽  
...  
Keyword(s):  
Rural Area ◽  
Malaria Diagnosis ◽  
Plasmodium Ovale ◽  
Plasmodium Ovale Curtisi ◽  
Southeastern Region

scholarly journals Evaluation of anaemia

2017 ◽  
Vol 5 (10) ◽  
pp. 4481 ◽  
Author(s):  
Suchita V. Ingale ◽  
Milind P. Ullewar ◽  
Vikas C. Ingale ◽  
Jayshree J. Upadhye
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Complete Blood Count ◽  
Severe Anaemia ◽  
Peripheral Smear ◽  
Pathology Laboratory ◽  
Mild Anemia ◽  
Normocytic Normochromic Anaemia ◽  
Moderate Anemia ◽  
Mild Anaemia

Background: Often, the first test used to diagnose anemia is a complete blood count (CBC). It determines the number, size, volume, and hemoglobin content of red blood cells. Peripheral smear is done for typing of anaemia. Such evaluation is necessary for proper treatment.Methods: A retrospective study was done in 300 anaemic patients at Shakuntala pathology laboratory, Nagpur. Patients were randomly selected including males and females. CBC and peripheral smear were analyzed.Results: Out of total 300 patients evaluated, the prevalence of anaemia was quite significant in females 225 (75%) than males 75 (25%). 66 females (22%) had mild anemia while 129 females (43%) had moderate anemia and 30 females (10%) had severe anaemia 36 males (12%) had mild anaemia, 30 males (10%) had moderate anaemia while 9 males (3%) had severe anaemia. In morphology of red blood cells, normocytic normochromic anaemia was seen in 132 (44%) females and in 45 (15%) of males. Microcytic hypochromic anaemia was seen in 90 (30%) females and 27 (9%) males. Macrocytic anaemia was seen in 3 (1%) females and 3 (1%) males.Conclusions: Prevalence of anaemia is quite high in females than males. Also, the severity of anaemia is more in females than males. So, heath programmes should be directed more towards females since adolescent age.

Assessment of the Accuracy of Malaria Microscopy in Private Health Facilities in Entebbe Municipality, Uganda; A Cross-sectional Study

2021 ◽  
Author(s):  
Tobius Mutabazi ◽  
Emmanuel Arinaitwe ◽  
Alex Ndyabakira ◽  
Emmanuel Sendaula ◽  
Alex Kakeeto ◽  
...  
Keyword(s):  
Predictive Value ◽  
Malaria Diagnosis ◽  
Clinical Information ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Factors Associated ◽  
Expert Microscopy ◽  
Malaria Microscopy

Abstract Introduction: Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. We evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda.Methods: Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results: The prevalence of malaria parasitemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1% and 99.2% respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; 1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [OR] = 9.74, 95% Confidence Interval [CI] (1.06 – 89.5), p-value=0.04), and 2) who was examining less than 5 smears a day (OR = 38.8, 95% CI 9.65- 156, p-value <0.001).Conclusion: The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector.

Evaluation Of Malaria Microscopy Diagnosis Performance In Public Hospitals Of Eastern And Centeral Part Of Oromia Region, Ethiopia, 2019

2020 ◽  
Author(s):  
Fraol Jaleta ◽  
Getinet Garoma ◽  
Tadesse Gerenfes
Keyword(s):  
Species Identification ◽  
Work Experience ◽  
Malaria Diagnosis ◽  
Study Data ◽  
Public Hospitals ◽  
Kappa Statistics ◽  
Public Health Response ◽  
Cross Sectional ◽  
Factors Associated ◽  
Malaria Microscopy

Abstract Back ground: Prompt and accurate malaria diagnosis is essential strategies for effective malaria case management as well as the public health response to malaria. Diagnosis based on clinical grounds alone may lead to misdiagnosis and mistreatment. The objective of this study is to evaluate the performance of malaria microscopy diagnosis public hospitals of Eastern and Central part Oromia, Ethiopia Method : Hospital based cross sectional study was conducted from March, 2019 to May, 2019. All 46 public hospitals of 12 zones in Eastern and Central parts of Oromia, Ethiopia were included in the study. Data were collected using Semi structured questionnaire and known validated positive and negative slides with different species, stage and parasite density distributed to each health facility. It was categorized and cleaned by Epi Info version 3.5.1 and analyzed by SPSS version 20 with multivariate analysis to identify factors associated with poor malaria microscopy diagnosis. Level of agreement was calculated by Kappa statistics. Results: From the total of 46 hospitals , 31 (67.39%) had acceptable quality performance with cumulative grading score of > 80%. The overall percentage of agreement in detection and species identification was 80.45% (Kappa=0.79) and 63.03% (Kappa=0. 38). Laboratory professionals who had work experience greater than five years were 10.56 times better in detecting and identifying malaria parasite when compared to those who had work experience less than or equal to five years (AOR [95%CI]=10.56[1.45-76.73]) . Laboratory professionals who were trained on malaria microscopy diagnosis were 1.28 times reported better quality results than those who were not trained (AOR, % 95CI=1.28[1.5-48.13]) Conclusion: The overall agreement of laboratory professionals in detection and species identification was with substantial and fair with kappa value 0.79 and 0.38 respectively. There were also gaps in correctly reporting stages identification and parasite count from distributed slides. Lack of Training and low work experience of laboratory professionals were factors associated with malaria microscopy diagnostic performance. Hence, capacitating laboratory professionals is essential to ensure good performance of malaria microscopy which reduces misdiagnosis of malaria parasites and mistreatment of malaria suspected patients.

scholarly journals Mentorship on malaria microscopy diagnostic service in Ethiopia: Baseline competency of microscopists and performance of health facilities

2021 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Microscopic Diagnosis ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria cases are declining as a result of proven interventions and in 2017, the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 1st to September 30th, 2019 in nine regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked, and proficiency of microscopists was tested using WHO certified slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, the sensitivity, the specificity, and the positive and negative predictive values were calculated.Results: In this study, 102 health facilities (84 health centers and 18 hospitals) were included; from which, 202 laboratory professionals participated. In slide re-checking, moderate agreement (Agreement: 76.0%; Kappa: 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1% and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Therefore, implementing comprehensive malaria microscopy mentorship, in-service training, and supportive supervision are the key strategies to improve the overall performance of health facilities in malaria microscopy.

scholarly journals Hematologic Changes in Patients with Graves’ disease in Gorgan During 2014-2015

2017 ◽  
Vol 2 (3) ◽  
pp. 106
Author(s):  
Maryam Zahedi ◽  
Farzam Mirkamali ◽  
Sharabeh Hezarkhani ◽  
Armineh Motiee ◽  
Arash Rezaei Shahmirzadi ◽  
...  
Keyword(s):  
Blood Cells ◽  
Complete Blood Count ◽  
Statistical Significance ◽  
White Blood Cells ◽  
P Value ◽  
Graves Disease ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
Mild Anemia ◽  
Before And After

Background: The most common cause of hyperthyroidism in areas without iodine deficiency is Graves’ disease. There are reports of some hematological alterations in hyperthyroidism. This study was designed to measure the hematologic profile in the patients with Graves’ disease before and after the treatment.Methods: In this cross-sectional study, 100 patients were selected with convenience sampling that diagnosed as autoimmune Graves’ disease in our academic endocrinology clinic during 2014-2015. Inclusion criteria included autoimmune hyperthyroidism in patients who were referred to this center during the study period. Patients who refused to take part in the research, had recent infections disease, malignancies, surgical procedures, severe trauma, received immunosuppressive drugs or corticosteroids, high erythrocyte sedimentation rate (ESR) values during the last six months, and not responded to treatment with methimazole were excluded from the study. The simple sampling technique was used to select the patients.   A complete blood count (CBC) was taken before and after treatment. The P-value less than 0.05 was considered as the statistical significance level. All data were analyzed using the Statistical Package for the Social Sciences 16.0 (SPSS Inc., Chicago, IL, USA) software.Results: One hundred patients with a mean age of 38 ± 9.8 years were included. There were no significant changes in the white blood cells (WBC) count, red blood cells (RBC) count, and platelets. Mild anemia (Hb=12.16±1.23) present before treating the hyperthyroidism that was significantly improved after treatment (P= 0.000). Conclusions: Our results showed that the only significant hematologic change in patients with Graves’ disease was mild anemia that improves after treating the underlying thyroid disorder. 

scholarly journals Impact of malaria diagnostic refresher training programme on competencies and skills in malaria diagnosis among medical laboratory professionals: evidence from Ghana 2015–2019

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mary Tetteh ◽  
Duah Dwomoh ◽  
Alexander Asamoah ◽  
Edward King Kupeh ◽  
Keziah Malm ◽  
...  
Keyword(s):  
Species Identification ◽  
Malaria Diagnosis ◽  
World Health ◽  
Medical Laboratory ◽  
Median Score ◽  
Malaria Parasites ◽  
Refresher Training ◽  
Post Test ◽  
Medical Laboratory Professionals ◽  
Malaria Microscopy

Abstract Background The quality of malaria test results is crucial for optimal patient treatment and care. The Ghana Health Service is successfully shifting from presumptive clinical diagnosis and treatment of malaria to the Test, Treat and Track (T3) initiative. In line with the initiative, the National Malaria Control Programme (NMCP) set out to improve the capacity of medical laboratory professionals in Ghana through a five-day Malaria Diagnostic Refresher Training (MDRT) to build competencies and skills in malaria diagnosis, especially in the three components of microscopy: parasite detection, species identification and parasite quantification. This study evaluates the impact of the training on malaria microscopy. Methods The training which was based on the World Health Organization basic malaria microscopy training guide employed presentations and practical approaches to malaria diagnosis. A total number of 765 medical laboratory professionals from various health facilities across the country were trained every other year from 2015 to 2019 and were included in this evaluation. Evaluation of this training was done using pre-test and post-test microscopy scores. The Negative Binomial fixed effect model was used in determining the overall effect of the training in improving the competencies of the participants on malaria microscopy. Results The ability of the medical laboratory professionals to correctly detect malaria parasites increased significantly from a median score of 64% prior to the training to 87% after the training (p < 0.001). The competencies of the medical laboratory scientists to correctly identify malaria parasite species and quantify the number of malaria parasites increased significantly from a median score of 17% and 20% pre-test to 78% and 50% post-test, respectively (p < 0.001). The results showed that participants’ competency level and skill to perform malaria microscopy (species identification, parasite quantification and detection of malaria parasites) increased by approximately two folds after the training compared to the no-training scenario (adjusted rate ratio = 2.07, 95% CI 2.01–2.13, p < 0.001). Conclusion The MDRT programme significantly improved participants’ performance of malaria microscopy over a short period of time.

scholarly journals Mentorship on Malaria Microscopy Diagnostic Service in Ethiopia: Baseline Competency of Microscopists and Performance of Health Facilities

2020 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria case is declining as a result of proven interventions and the country launched malaria elimination strategy in targeted settings since 2017. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop continuation of the transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out toevaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 01 to September 30, 2019 in nine Regional States and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using WHO certified slides from national slide bank in public health institute. Strength of agreement, sensitivity, specificity and positive and negative predictive values were calculated.Results: In this study, 102 health facilities (84 health centers and 18 hospitals) were included; from which, 202 laboratory professionals participated. In slide re-checking, moderate agreement (Agreement: 76.0%; Kappa: 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the rechecking results were 78.1% and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Therefore, implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are the key strategies to improve the overall performance of health facilities in malaria microscopy.

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