Abstract:Malaria is the leading cause of mortality among under-fives in the sub-Saharan Africa. The gold standard method for the diagnosis of malaria is by the use of microscopy which is time consuming and requires skilled technicians. Recently the cost effective antigen based rapid diagnostic tests (RDTs) such as ParaHITf have been introduced in various places for the diagnosis of malaria. The choice of these RDTs to use in a certain country and specific geographical locations is critical to malaria diagnosis, treatment and ultimately control of drug resistance. This study was conducted to evaluate the sensitivity and specificity of the cheapest and easily available RDT in the study area, using microscopy as gold standard. This cross-sectional study was conducted to determine the performance of ParaHIT-f in diagnosing malaria in 300 children attending outpatient department at Butimba district hospital, Tanzania. Two thick and one thin blood smear were stained using standard Giemsa stain. The prevalence of Plasmodum falcparum malaria was 5.7% and 15.7% by ParaHIT-f and microscopy, respectively; the difference was significant (P<0.001). The sensitivity and specificity of ParaHIT-f were 29.8% and 98.8% respectively. There was a strong association between parasitaemia of ≥1000parasites/µl and being positive for ParaHIT-f diagnostic test (P <0.001). There is a need to revisit the use of ParaHIT-f in Tanzania. Further studies on the sensitivity and specificity are needed. A good quality control system on the performance of ParaHIT-f and other RDTs is highly recommended.
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Vector control using treated nets and recently industrially long lasting insecticidal nets (LLINs) have played a vital role in malaria control globally. The emergence of insecticides resistance among malaria vector against pyrethroids has raised a concern over achieved a milestone. Different insecticides resistance mechanisms have evolved against pyrethroids. This has given mosquitoes an opportunity to increase survivor fitness. The incorporation of synegistic effect of Piperonyl Butoxide (PBO) in LLINs has shown a significant impact in areas with pyrethroid resistant malaria vectors than LLIN without PBO. LLINs with PBO for management of resistance can revive pyrethroid strength against resistant malaria vectors. There is a necessity for National malaria control and other NGOs in Africa distributing LLINs to distribute nets with pyrethroids and PBO.
Malaria cases management and treatment need to have accurate and reliable diagnostic tools. Thus the present study evaluated the sensitivity and specificity of the test against expert microscopy in febrile under-five children in Sengerema District, north-western Tanzania. A finger prick blood sample was obtained from each child, and thin and thick blood smears were prepared, stained with 10% Giemsa and examined under the light microscope and ClearView Malaria Dual rapid test. A total of 232 children were included in the study. Of these, 29 (12.50%, 95%CI, 8.20-16.8) children had a positive malaria microscopy and 44 (18.97%, 95%CI, 13.9-23.9) were positive in the rapid diagnostic test. The sensitivity of the rapid diagnostic test increased with increasing P. falciparum geometric mean parasite density from 46.43% (95%CI, 39.72-53.1) at <200 parasites/μL to 93.75% (95%CI,.01) at ≥ 200 parasites/μL. ClearView Malaria Dual rapid test is highly specific and its sensitivity increases with increase in parasite density. The test could be used in holoendemic areas but its use in areas with low malaria transmission needs further evaluation.
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