Malaria Reports

Evaluating the use of microscopic examination and rapid diagnostic tests to diagnose malaria in North Central Nigeria

2016-05-18T14:26:00+00:00

The global impact of malaria has spurred interest in developing prompt and accurate diagnostic strategies to provide an effective management of the disease. The aim of this study was to compare rapid diagnostic tests (RDTs) for malaria with routine microscopy. Samples were collected randomly from 364 febrile out-patients with clinical suspicion of malaria from four hospitals in North Central Nigeria. Results from the rapid diagnostic kits were analysed and compared to those obtained by general microscopy. Of the 364 out-patients involved in the study, 218 (59.89%) tested positive for Plasmodium falciparum by RDTs, whereas 263 (72.256%) tested positive by microscopy. There are significant differences (P<0.05) in infection rates between RDT and microscopy. The sensitivity, specificity and negative predictive values of RDTs compared to microscopy are low, while the positive predictive value is high. Evaluation of RDTs against the parasite-positive panel with parasite densities of <1000 parasites/μL, between 1000-5000 parasites/μL and above 5000 parasites/ μL was 11.73, 30.61, 57.65% for RDTs compared to 6.11, 27.95 and 65.94% for microscopy, respectively. Test line intensity increases with increase in parasite densities for both methods.

A rapid, low-cost methodology for longitudinal evaluation of insecticide treated bednet distributions: a pilot survey coupling bednet usage with malaria prevalence at the household level

2016-05-18T14:25:57+00:00

Tanzania’s National Malaria Control Program distributed 23.3 million insecticidetreated bed nets (ITNs) between 2009 and 2011. Annual randomized household surveys were conducted from 2009 to 2011 to assess the incremental effects of the distribution campaign on malaria prevalence and bednet usage in Kijumbura village in Kagera, Tanzania. Data was collected about household ITN ownership and individual use, and each household member was given a rapid malaria diagnostic test (RDT). In total, 1247 individuals from 285 households participated. From 2009 to 2011, household ITN ownership increased from 50.6 to 95.3% and individual usage increased from 9.7 to 55.3% in 2011. Malaria point prevalence decreased from 15.8% in 2009 to 6.5% in 2010, and increased from 6.5% in 2010 to 10.7% in 2011. The survey cost in 2011 was 23.50 USD per household; major expenses were transportation, personnel payment, and the purchase of the RDTs. Evaluations of bednet distribution programs generally rely on distribution data and selfreported net ownership, but it is important to also assess the goal endpoint of reduction in malaria prevalence. We show that this can be achieved quickly and cost-effectively through randomized surveys measuring bednet usage coupled with malaria prevalence at the household level.

Caretakers’ self adherence to artemisinin lumefantrine in Nyando district, Kenya

2016-05-18T14:26:02+00:00

Artemisinin combination therapies (ACTs) are effective and tolerant. However, the continuous development of Plasmodium strains resistance to cost effective monotherapies such as chloroquine and sulphadoxinepyrimethamine, remains the greatest setback to the global fight against malaria. Recent studies indicate that Plasmodium parasites are already becoming resistance to ACTs. A number of factors such as poor adherence can cause drug failure. Non-adherence is one of the major challenges facing optimal use of ACTs in real life settings. The objective of this study was to describe and identify factors associated with non-adherence to artemisinin lumefantrine (AL) among malaria-ailing caretakers seen in Nyando district hospital who also had children under the age of five ailing from malaria. From our study we concluded that the consents, follow-ups, strict adherence to the Kenya National Strategy for Control and Treatment of Malaria guidelines and availability of AL during the study may have influenced the observed high adherence rates. Therefore, it is critical to adequately stock health facilities with AL to enhance adherence. More specifically, healthcare providers need to educate malaria-ailing caretakers on the AL regimen as well as its possible side effects to promote adherence to the antimalarial at a household level.