Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.

<h4>Background</h4>Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy.<h4>Methods</h4...

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Autores principales: Tekola Endeshaw, Patricia M Graves, Berhan Ayele, Aryc W Mosher, Teshome Gebre, Firew Ayalew, Asrat Genet, Alemayehu Mesfin, Estifanos Biru Shargie, Zerihun Tadesse, Tesfaye Teferi, Berhanu Melak, Frank O Richards, Paul M Emerson
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spelling oai:doaj.org-article:e899ae0848e446b3896d61ee274bfdfc2021-11-18T07:21:30ZPerformance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.1932-620310.1371/journal.pone.0033014https://doaj.org/article/e899ae0848e446b3896d61ee274bfdfc2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22536317/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy.<h4>Methods</h4>Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists.<h4>Results</h4>Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P. falciparum, 24.6% P. vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%.<h4>Conclusions</h4>Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.Tekola EndeshawPatricia M GravesBerhan AyeleAryc W MosherTeshome GebreFirew AyalewAsrat GenetAlemayehu MesfinEstifanos Biru ShargieZerihun TadesseTesfaye TeferiBerhanu MelakFrank O RichardsPaul M EmersonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e33014 (2012)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Tekola Endeshaw
Patricia M Graves
Berhan Ayele
Aryc W Mosher
Teshome Gebre
Firew Ayalew
Asrat Genet
Alemayehu Mesfin
Estifanos Biru Shargie
Zerihun Tadesse
Tesfaye Teferi
Berhanu Melak
Frank O Richards
Paul M Emerson
Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
description <h4>Background</h4>Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy.<h4>Methods</h4>Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists.<h4>Results</h4>Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P. falciparum, 24.6% P. vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%.<h4>Conclusions</h4>Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.
format article
author Tekola Endeshaw
Patricia M Graves
Berhan Ayele
Aryc W Mosher
Teshome Gebre
Firew Ayalew
Asrat Genet
Alemayehu Mesfin
Estifanos Biru Shargie
Zerihun Tadesse
Tesfaye Teferi
Berhanu Melak
Frank O Richards
Paul M Emerson
author_facet Tekola Endeshaw
Patricia M Graves
Berhan Ayele
Aryc W Mosher
Teshome Gebre
Firew Ayalew
Asrat Genet
Alemayehu Mesfin
Estifanos Biru Shargie
Zerihun Tadesse
Tesfaye Teferi
Berhanu Melak
Frank O Richards
Paul M Emerson
author_sort Tekola Endeshaw
title Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
title_short Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
title_full Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
title_fullStr Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
title_full_unstemmed Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.
title_sort performance of local light microscopy and the parascreen pan/pf rapid diagnostic test to detect malaria in health centers in northwest ethiopia.
publisher Public Library of Science (PLoS)
publishDate 2012
url https://doaj.org/article/e899ae0848e446b3896d61ee274bfdfc
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