Overdiagnosis of Malaria Illness in an Endemic Setting: A Facility-Based Surveillance Study in Malawi

2021 ◽  
Author(s):  
Ingrid Peterson ◽  
Atupele Kapito-Tembo ◽  
Andrew Bauleni ◽  
Osward Nyirenda ◽  
Paul Pensulo ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Infection ◽  
Febrile Illness ◽  
School Age Children ◽  
Smear Microscopy ◽  
Asymptomatic Malaria ◽  
School Age ◽  
Malaria Rapid Diagnostic Tests ◽  
Outpatient Departments ◽  
Outpatient Settings

In endemic settings where asymptomatic malaria infections are common, malaria infection can complicate fever diagnosis. Factors influencing fever misdiagnosis, including accuracy of malaria rapid diagnostic tests (mRDTs) and the malaria-attributable fraction of fevers (MAF), require further investigation. We conducted facility-based surveillance in Malawi, from January 2012 through December 2013 in settings of high perennial (Chikhwawa), high seasonal (Thoylo), and moderate seasonal (Ndirande) malaria transmission. Consecutive patients presenting to outpatient departments were screened; those with suspected malaria illness were tested by mRDT or routine thick-smear microscopy. Test positivity rates (TPRs), positive predictive value (PPVs) of mRDTs, and MAFs were calculated by site, age, and season. Of 41,471 patients, 10,052 (24.2%) tested positive for malaria. The TPR was significantly greater in Chikhwawa (29.9%; 95% CI, 28.6–30.0) compared with Thyolo (13.2%; 95% CI, 12.5–13.7) and Ndirande (13.1%; 95% CI, 12.2–14.4). The overall PPV was 77.8% (95% CI, 76.8–78.7); it was lowest among infants (69.9%; 95% CI, 65.5–74.2) and highest among school-age children (81.9%; 95% CI, 80.3–83.4). Malaria infection accounted for about 50% of fevers in children younger than 5 years old with microscopy-confirmed Plasmodium falciparum infection, and less than 20% of such fevers in school-age children. Outpatient settings in Malawi had a high burden of malaria illness, but also possible overdiagnosis of malaria illness. Interventions to reduce malaria transmission and rapid testing for other common febrile illness may improve diagnostic clarity among outpatients in malaria endemic settings.

scholarly journals Malaria Parasite Species Composition of Plasmodium Infections Among Asymptomatic and Symptomatic School-Age Children in Rural and Urban Areas of Kinshasa, Democratic Republic of Congo

2021 ◽  
Author(s):  
Sabin S. Nundu ◽  
Richard Culleton ◽  
Shirley V. Simpson ◽  
Hiroaki Arima ◽  
Jean-Jacques Muyembe ◽  
...  
Keyword(s):  
Urban Area ◽  
Rural Area ◽  
Malaria Parasite ◽  
Parasite Species ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
School Age Children ◽  
Asymptomatic Malaria ◽  
School Age ◽  
Republic Of Congo

Abstract Background. Malaria remains a major public health concern in Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC.Methods. 634 (427 asymptomatic and 207 symptomatic) blood samples were collected from a cross-sectional survey of school-age children aged 6 to 14 years both without and with malaria symptoms. Nested-PCR was performed for malaria parasite species typing. Results. The overall prevalence of Plasmodium spp., Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale was 62.3, 58.1, 19.9 and 10.8% among asymptomatic whereas it was 94.4, 93.2, 12.6 and 15.9% in symptomatic children, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p<0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p<0.001). Amongst asymptomatic malaria parasite carriers, 43% of children in the rural area were co-infected with two or more species with P. falciparum + P. malariae the most common (24%) whereas in the urban setting, fewer children carried co-infections (16%) with P. falciparum + P. malariae again the most common (9%). A fifth of rural-dwelling symptomatic children were co-infected with two or more species with P. falciparum + P. ovale the most common (14%), while a quarter of symptomatic children in the urban area carried multiple species, with co-infections of P. falciparum + P. malariae the most common (11%). Conclusion. School-age children are at significant risk from both asymptomatic and symptomatic malaria parasite infections. Continuous systematic screening and treatment of school-age children in high-transmission settings across the country may reinforce malaria intervention measures.

scholarly journals Xerophthalmia and Its Associated Factors among School-Age Children in Amba Giorgis Town, Northwest Ethiopia, 2018

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Gizachew Tilahun Belete ◽  
Assefa Lake Fenta ◽  
Mohammed Seid Hussen
Keyword(s):  
Logistic Regression ◽  
Low Income ◽  
Associated Factors ◽  
Fruits And Vegetables ◽  
Febrile Illness ◽  
Northwest Ethiopia ◽  
World Health ◽  
School Age Children ◽  
School Age ◽  
Study Participants

Introduction. Xerophthalmia is a general term applied to all the ocular manifestations from night blindness through complete corneal destruction (keratomalacia) due to vitamin A deficiency. Xerophthalmia is the main contributing factors for childhood blindness in developing countries. However, there is limited evidence that can implicate the current situation. This study aimed to determine the magnitude of xerophthalmia and associated factors among school-age children in Northwest Ethiopia. Methods. A community-based cross-sectional study was conducted on 490 children, age range of 6 to 12 years. The study participants were selected through systematic random sampling method. Data were collected using a pretested structured questionnaire and ophthalmic examination with different ophthalmic instruments. The analyzed result was summarized and presented using descriptive statistics. Binary logistic regression was used to determine the factors associated with xerophthalmia. Variables with a p value of <0.05 in the multivariable logistic regression analysis were considered as statistically significant. Results. A total of 484 study participants with a response rate of 98.8 were involved in this study, and their median age was 8 years with IQR of 4 years. The prevalence of xerophthalmia was 8.26% (95% CI: 5.8, 10.7). Family income less than 1000 Ethiopian birr (AOR = 4.65, 95% CI: 1.31, 16.4), presence of febrile illness (AOR = 2.8, 95% CI: 1.49, 6.11), poor consumption of fruits and vegetables (AOR = 3.18, 95% CI: 1.30, 7.80), and nonimmunized status (AOR = 3.43, 95% CI: 1.49, 7.89) were significantly associated with xerophthalmia. Conclusions and recommendations. The prevalence of xerophthalmia was high as compared to the World Health Organization criteria for public health significance. Factors identified for xerophthalmia in this study are low income, the poor dietary practice of fruits and vegetables, and the presence of febrile illness and not immunized. Hence, it is a public problem that needs attention.

scholarly journals School-Age Children Are a Reservoir of Malaria Infection in Malawi

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0134061 ◽  
Author(s):  
Jenny A. Walldorf ◽  
Lauren M. Cohee ◽  
Jenna E. Coalson ◽  
Andy Bauleni ◽  
Kondwani Nkanaunena ◽  
...  
Keyword(s):  
Malaria Infection ◽  
School Age Children ◽  
School Age

scholarly journals Malaria parasite species composition of Plasmodium infections among asymptomatic and symptomatic school-age children in rural and urban areas of Kinshasa, Democratic Republic of Congo

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sabin S. Nundu ◽  
Richard Culleton ◽  
Shirley V. Simpson ◽  
Hiroaki Arima ◽  
Jean-Jacques Muyembe ◽  
...  
Keyword(s):  
Urban Area ◽  
Urban Areas ◽  
Malaria Parasite ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
School Age Children ◽  
Asymptomatic Malaria ◽  
School Age ◽  
Republic Of Congo ◽  
Symptomatic Malaria

Abstract Background Malaria remains a major public health concern in the Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC. Methods A total of 634 (427 asymptomatic and 207 symptomatic) blood samples collected from school-age children aged 6 to 14 years were analysed by microscopy, RDT and Nested-PCR. Results The overall prevalence of Plasmodium spp. by microscopy, RDT and PCR was 33%, 42% and 62% among asymptomatic children and 59%, 64% and 95% in symptomatic children, respectively. The prevalence of Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale spp. by PCR was 58%, 20% and 11% among asymptomatic and 93%, 13% and 16% in symptomatic children, respectively. Among P. ovale spp., P. ovale curtisi, P. ovale wallikeri and mixed P. ovale curtisi + P. ovale wallikeri accounted for 75%, 24% and 1% of infections, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p < 0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p < 0.001). Amongst asymptomatic malaria parasite carriers, 43% and 16% of children harboured mixed Plasmodium with P. falciparum infections in the rural and the urban areas, respectively, whereas in symptomatic malaria infections, it was 22% and 26%, respectively. Few children carried single infections of P. malariae (2.2%) and P. ovale spp. (1.9%). Conclusion School-age children are at significant risk from both asymptomatic and symptomatic malaria infections. Continuous systematic screening and treatment of school-age children in high-transmission settings is needed.

scholarly journals Clinical and epidemiological features of the course of the new coronavirus infection COVID-19 in children during periods of an increase in the incidence in Moscow in 2020-2021

2021 ◽  
Vol 20 (3) ◽  
pp. 5-10
Author(s):  
L. N. Mazankova ◽  
E. R. Samitova ◽  
I. M. Osmanov ◽  
I. I. Afukov ◽  
N. A. Dracheva ◽  
...  
Keyword(s):  
School Age Children ◽  
Hospitalized Children ◽  
School Age ◽  
Number Of Children ◽  
Early Admission ◽  
Epidemiological Features ◽  
Fold Reduction ◽  
Coronavirus Infection ◽  
Outpatient Settings ◽  
The City

Purpose: to identify the features of COVID-19 infection in children at different periods of the epidemiological rise in the incidence in the city of Moscow.Results. The article presents the observation of 1561 children hospitalized in the State Medical Institution «Children's City Clinical Hospital named after Z. A. Bash-lyaeva DZM» with a diagnosis of a new coronavirus infection COVID-19 during the periods of epidemiological rises in morbidity («2nd and 3rd waves of COVID-19»). An increase in the number of hospitalized children during the «3rd wave of COVID-19», early admission dates from the onset of the disease, due to the lack of treatment effect in outpatient settings, the predominance of school-age children and adolescents, the predominant course of infection with the development of viral pneumonia CT2-3, less often CT3-4, a 10-fold reduction in the number of children with MIS-syndrome, an elongation of the period of viral release in patients.

A Therapeutic Technique for the Improvement of Lingua-Alveolar Valving Abilities

1978 ◽  
Vol 9 (3) ◽  
pp. 169-175 ◽  
Author(s):  
James Paul Dworkin
Keyword(s):  
School Age Children ◽  
School Age ◽  
Bite Block ◽  
Therapeutic Technique ◽  
Remedial Program

This study was designed to determine if a remedial program using a bite-block device could inhibit hypermandibular activity (HMA) and thereby improve the lingua-alveolar valving (LAV) abilities of four school-age children who demonstrated multiple lingua-alveolar (LA) phonemic errors. The results revealed significant improvements in LAV and LA phoneme articulatory skills in all of the children who used the bite-block device to reduce HMA subsequent to comprehensive training sessions.

Dimensions of Multiskilling

1999 ◽  
Vol 30 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Carole E. Johnson
Keyword(s):  
Hearing Loss ◽  
Service Delivery ◽  
Monitoring Program ◽  
School Age Children ◽  
School Age ◽  
Support Personnel ◽  
Educational Personnel ◽  
Educational Audiology ◽  
Children With Hearing Loss ◽  
Improve Service Delivery

Educational audiologists often must delegate certain tasks to other educational personnel who function as support personnel and need training in order to perform assigned tasks. Support personnel are people who, after appropriate training, perform tasks that are prescribed, directed, and supervised by a professional such as a certified and licensed audiologist. The training of support personnel to perform tasks that are typically performed by those in other disciplines is calledmultiskilling. This article discusses multiskilling and the use of support personnel in educational audiology in reference to the following principles: guidelines, models of multiskilling, components of successful multiskilling, and "dos and don’ts" for multiskilling. These principles are illustrated through the use of multiskilling in the establishment of a hearing aid monitoring program. Successful multiskilling and the use of support personnel by educational audiologists can improve service delivery to school-age children with hearing loss.

Perceptions of Stuttering of Different Age Groups

2019 ◽  
Vol 4 (6) ◽  
pp. 1311-1315
Author(s):  
Sergey M. Kondrashov ◽  
John A. Tetnowski
Keyword(s):  
Age Groups ◽  
School Age Children ◽  
Clinical Implications ◽  
School Age ◽  
Fourth Edition ◽  
Self Perception ◽  
Behavioral Measures ◽  
Self Rating ◽  
Comparison Results ◽  
Subject Pool

Purpose The purpose of this study was to assess the perceptions of stuttering of school-age children who stutter and those of adults who stutter through the use of the same tools that could be commonly used by clinicians. Method Twenty-three participants across various ages and stuttering severity were administered both the Stuttering Severity Instrument–Fourth Edition (SSI-4; Riley, 2009 ) and the Wright & Ayre Stuttering Self-Rating Profile ( Wright & Ayre, 2000 ). Comparisons were made between severity of behavioral measures of stuttering made by the SSI-4 and by age (child/adult). Results Significant differences were obtained for the age comparison but not for the severity comparison. Results are explained in terms of the correlation between severity equivalents of the SSI-4 and the Wright & Ayre Stuttering Self-Rating Profile scores, with clinical implications justifying multi-aspect assessment. Conclusions Clinical implications indicate that self-perception and impact of stuttering must not be assumed and should be evaluated for individual participants. Research implications include further study with a larger subject pool and various levels of stuttering severity.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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