Accuracy of malaria diagnosis by microscopy, rapid diagnostic test, and PCR methods and evidence of antimalarial overprescription in non-severe febrile patients in two Tanzanian hospitals

The study was aimed to evaluate the malaria over/underdiagnosis and over/underprescription of antimalarial drugs. Between February and March 2007 blood samples were collected from 336 non-severe febrile outpatients attended in two peripheral Tanzanian hospitals. Microscopy and a rapid diagnostic tes...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene Vol. 80; no. 5; p. 712
Main Authors: Nicastri, Emanuele, Bevilacqua, Nazario, Sañé Schepisi, Monica, Paglia, Maria G, Meschi, Silvia, Ame, Shaali M, Mohamed, Jape A, Mangi, Sabina, Fumakule, Robert, Di Caro, Antonino, Capobianchi, Maria R, Kitua, Andrew, Molteni, Fabrizio, Racalbuto, Vincenzo, Ippolito, Giuseppe
Format: Journal Article
Language:English
Published: United States 01.05.2009
Subjects:
Adolescent
Adult
Aged
Antimalarials - administration & dosage
Antimalarials - therapeutic use
Child
Child, Preschool
Cross-Sectional Studies
Drug Utilization
Female
Fever - diagnosis
Humans
Infant
Malaria - diagnosis
Malaria - drug therapy
Malaria - epidemiology
Male
Middle Aged
Tanzania - epidemiology
Young Adult
Tanzania
ISSN:1476-1645, 1476-1645
Online Access:Get more information
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Summary:The study was aimed to evaluate the malaria over/underdiagnosis and over/underprescription of antimalarial drugs. Between February and March 2007 blood samples were collected from 336 non-severe febrile outpatients attended in two peripheral Tanzanian hospitals. Microscopy and a rapid diagnostic test (RDT) were done locally and the accuracy evaluated by qualitative polymerase chain reaction (PCR) for Plasmodium spp. The testing was performed at National Institute for Infectious Diseases Lazzaro Spallanzani (INMI), Rome, Italy. As a result of PCR, we identified 26 malaria cases out of 336 (7.7%) patients. Microscopy and RDT accuracies were 93.5% and 97.6%, respectively. Overprescription and underdiagnosis rates were 29.3% and 30.8%, respectively. On-field training, clinical management of febrile illness, and malaria microscopy in remote settings should be considered.
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ISSN:1476-1645
1476-1645
DOI:10.4269/ajtmh.2009.80.712