Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.

<h4>Background</h4>WHO now recommends test-based management of malaria across all transmission settings. The accuracy of rapid diagnostic test (RDT) and the outcome of treatment based on the result of tests will influence acceptability of and adherence to the new guidelines.<h4>Met...

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Autores principales: Frank Baiden, Jayne Webster, Mathilda Tivura, Rupert Delimini, Yvonne Berko, Seeba Amenga-Etego, Akua Agyeman-Budu, Akosua B Karikari, Jane Bruce, Seth Owusu-Agyei, Daniel Chandramohan
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spelling oai:doaj.org-article:fa58bc2a79c548b58a33f2f10f96e8212021-11-18T07:22:21ZAccuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.1932-620310.1371/journal.pone.0034073https://doaj.org/article/fa58bc2a79c548b58a33f2f10f96e8212012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22514617/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>WHO now recommends test-based management of malaria across all transmission settings. The accuracy of rapid diagnostic test (RDT) and the outcome of treatment based on the result of tests will influence acceptability of and adherence to the new guidelines.<h4>Method</h4>We conducted a study at the Kintampo hospital in rural Ghana to evaluate the performance of CareStart, a HRP-2 based RDT, using microscopy as reference. We applied IMCI treatment guidelines, restricted ACT to RDT-positive children and followed-up both RDT-positive (malaria) and RDT-negative (non-malaria) cases over 28 days.<h4>Results</h4>436 children were enrolled in the RDT evaluation and 391 (children with haemoglobin >8.0 gm/dl) were followed-up to assess treatment outcomes. Mean age was 25.4 months (s.d. 14.6). Sensitivity and specificity of the RDT were 100.0% and 73.0% respectively. Over the follow-up period, 32 (18.5%) RDT-negative children converted to positive, with 7 (4.0%) of them presenting with fever. More children in the non-malaria group made unscheduled visits than children in the malaria group (13.3% versus 7.7%) On all scheduled follow-up visits, proportion of children having a temperature higher than that recorded on day 0 was higher in the non-malaria group compared to the malaria group. Reports of unfavourable treatment outcomes by caregivers were higher among the non-malaria group than the malaria group.<h4>Conclusions</h4>The RDT had good sensitivity and specificity. However a minority of children who will not receive ACT based on RDT results may develop clinical malaria within a short period in high transmission settings. This could undermine caregivers' and health workers' confidence in the new guidelines. Improving the quality of management of non-malarial febrile illnesses should be a priority in the era of test-based management of malaria.<h4>Trial registration</h4>ClinicalTrials.gov NCT00832754.Frank BaidenJayne WebsterMathilda TivuraRupert DeliminiYvonne BerkoSeeba Amenga-EtegoAkua Agyeman-BuduAkosua B KarikariJane BruceSeth Owusu-AgyeiDaniel ChandramohanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e34073 (2012)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Frank Baiden
Jayne Webster
Mathilda Tivura
Rupert Delimini
Yvonne Berko
Seeba Amenga-Etego
Akua Agyeman-Budu
Akosua B Karikari
Jane Bruce
Seth Owusu-Agyei
Daniel Chandramohan
Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
description <h4>Background</h4>WHO now recommends test-based management of malaria across all transmission settings. The accuracy of rapid diagnostic test (RDT) and the outcome of treatment based on the result of tests will influence acceptability of and adherence to the new guidelines.<h4>Method</h4>We conducted a study at the Kintampo hospital in rural Ghana to evaluate the performance of CareStart, a HRP-2 based RDT, using microscopy as reference. We applied IMCI treatment guidelines, restricted ACT to RDT-positive children and followed-up both RDT-positive (malaria) and RDT-negative (non-malaria) cases over 28 days.<h4>Results</h4>436 children were enrolled in the RDT evaluation and 391 (children with haemoglobin >8.0 gm/dl) were followed-up to assess treatment outcomes. Mean age was 25.4 months (s.d. 14.6). Sensitivity and specificity of the RDT were 100.0% and 73.0% respectively. Over the follow-up period, 32 (18.5%) RDT-negative children converted to positive, with 7 (4.0%) of them presenting with fever. More children in the non-malaria group made unscheduled visits than children in the malaria group (13.3% versus 7.7%) On all scheduled follow-up visits, proportion of children having a temperature higher than that recorded on day 0 was higher in the non-malaria group compared to the malaria group. Reports of unfavourable treatment outcomes by caregivers were higher among the non-malaria group than the malaria group.<h4>Conclusions</h4>The RDT had good sensitivity and specificity. However a minority of children who will not receive ACT based on RDT results may develop clinical malaria within a short period in high transmission settings. This could undermine caregivers' and health workers' confidence in the new guidelines. Improving the quality of management of non-malarial febrile illnesses should be a priority in the era of test-based management of malaria.<h4>Trial registration</h4>ClinicalTrials.gov NCT00832754.
format article
author Frank Baiden
Jayne Webster
Mathilda Tivura
Rupert Delimini
Yvonne Berko
Seeba Amenga-Etego
Akua Agyeman-Budu
Akosua B Karikari
Jane Bruce
Seth Owusu-Agyei
Daniel Chandramohan
author_facet Frank Baiden
Jayne Webster
Mathilda Tivura
Rupert Delimini
Yvonne Berko
Seeba Amenga-Etego
Akua Agyeman-Budu
Akosua B Karikari
Jane Bruce
Seth Owusu-Agyei
Daniel Chandramohan
author_sort Frank Baiden
title Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
title_short Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
title_full Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
title_fullStr Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
title_full_unstemmed Accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural Ghana.
title_sort accuracy of rapid tests for malaria and treatment outcomes for malaria and non-malaria cases among under-five children in rural ghana.
publisher Public Library of Science (PLoS)
publishDate 2012
url https://doaj.org/article/fa58bc2a79c548b58a33f2f10f96e821
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