A combined strategy for screening a clustered mobile population returning from highly endemic areas for Plasmodium falciparum

Li, Mei; Li, Jun; Xia, Zhigui; Xiao, Ning; Jiang, Weikang; Wen, Yongkang

doi:10.3855/jidc.8394

Cited by 3 publications

(4 citation statements)

References 14 publications

(23 reference statements)

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“…Effective malaria diagnostic tests of high accuracy and drugs for therapy must be accessible in a short time, providing the means of transporting medical services to migrant febrile patients or sending patients to superior healthcare centres [30]. A panel on malaria diagnostic and treatment of high mobility and the combination of microscopy and RDT for diagnosis are recommended here [47]. To ensure the least burden caused by imported malaria, related laws and regulations will become a fact in the future.…”

Section: Discussionmentioning

confidence: 99%

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Management of imported malaria cases and healthcare institutions in central China, 2012–2017: application of decision tree analysis

Wang

Cao

et al. 2019

Malar J

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Background: Imported malaria has been an important challenge for China. Fatality rates from malaria increased in China, particularly in Henan Province, primarily due to malpractice and misdiagnoses in healthcare institutions, and the level of imported malaria. This study aims to investigate the relationship between the state of diagnosis and subsequent complications among imported malaria cases at healthcare institutions, based on malaria surveillance data in Henan Province from 2012 to 2017. Methods: A retrospective descriptive analysis was performed using data from the Centre for Disease Control and Prevention, Zhengzhou City, the capital of Henan Province. A decision tree method was exploited to provide valuable insight into the correlation between imported malaria cases and healthcare institutions. Results: From 2012 to 2017, there were 371 imported malaria cases, mostly in males aged between 20 and 50 years, including 319 Plasmodium falciparum cases. First visits of 32.3%, 19.9% and 15.9% malaria cases for treatment were to provincial, municipal and county healthcare institutions, respectively. The time interval between onset and initial diagnosis of 284 cases (76.5%) and the time interval between initial diagnosis and final diagnosis of 197 cases (53.1%) was no more than 72 h. An apparent trend was found that there were notably fewer patients misdiagnosed at first visit to healthcare institutions of a higher administrative level; 12.5% of cases were misdiagnosed in provincial healthcare institutions compared to 98.2% in private clinics, leading to fewer complications at healthcare institutions of higher administrative level due to correct initial diagnosis. In the tree model, the rank of healthcare facilities for initial diagnosis, and number of days between onset and initial diagnosis, made a major contribution to the classification of initial diagnosis, which subsequently became the most significant factor influencing complications developed in the second tree model. The classification accuracy were 82.2 and 74.1%, respectively for the tree models of initial diagnosis and complications developed. Conclusion: Inadequate seeking medical care by imported malaria patients, and insufficient capacity to diagnose malaria by healthcare institutions of lower administrative level were identified as major factors influencing complications of imported malaria cases in Henan Province. The lack of connection between uncommon imported malaria

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Section: Discussionmentioning

confidence: 99%

“…Any unintended adverse effects arising from incorrect or overdue practice by individuals and healthcare institutions must be detected. Daily data services to improve health literacy, imperative demands to high-risk population, and reliable and productive professional support could be effectively implemented within the system [30,47,48].…”

Section: Discussionmentioning

confidence: 99%

Management of imported malaria cases and healthcare institutions in central China, 2012–2017: application of decision tree analysis

Wang

Cao

et al. 2019

Malar J

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“…They concluded that mRDTs were more sensitive than microscopy. Harchut and colleagues evaluated the cost efficiency of microscopy and mRDTs for malaria diagnosis in Southern Tanzania and found that use of mRDTs reduced government expenditure and facilitated rapid diagnosis of malaria ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…The main findings from our study were similar to those of other studies. Fançony and colleagues used polymerase chain reaction (PCR) as the gold standard and compared screening performance of microscopy and mRDTs in Angola (9). They concluded that mRDTs were more sensitive than microscopy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Malaria Standard Microscopy and Rapid Diagnostic Tests for Screening — Southern Tanzania, 2018–2019

Lin

Wang

et al. 2022

China CDC Weekly

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What is already known about this topic? Microscopy is the gold standard for parasitological confirmation, but the accuracy of microscopic diagnosis is influenced by the skill of the technicians. An alternative is the immunologic-based malaria rapid diagnostic tests (mRDTs). What is added by this report? Our study evaluated standard microscopy in health system (SMHS) and mRDTs for focused screening and treatment of malaria (FSAT) in Southern Tanzania. We showed that mRDTs were more sensitive than local SMHS for diagnosing malaria infection. What are the implications for public health practices? Malaria rapid diagnostic tests can be useful as an alternative to SMHS for FSAT in the local context of Tanzania.

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Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm

2021

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Malaria rapid diagnostic tests (RDTs) have had an enormous global impact which contributed to the World Health Organization paradigm shift from empiric treatment to obtaining a parasitological diagnosis prior to treatment. Microscopy, the classic standard, requires significant expertise, equipment, electricity, and reagents. Alternatively, RDT’s lower complexity allows utilization in austere environments while achieving similar sensitivities and specificities. Worldwide, there are over 200 different RDT brands that utilize three antigens: Plasmodium histidine-rich protein 2 (PfHRP-2), Plasmodium lactate dehydrogenase (pLDH), and Plasmodium aldolase (pALDO). pfHRP-2 is produced exclusively by Plasmodium falciparum and is very Pf sensitive, but an alternative antigen or antigen combination is required for regions like Asia with significant Plasmodium vivax prevalence. RDT sensitivity also decreases with low parasitemia (<100 parasites/uL), genetic variability, and prozone effect. Thus, proper RDT selection and understanding of test limitations are essential. The Center for Disease Control recommends confirming RDT results by microscopy, but this is challenging, due to the utilization of clinical laboratory standards, like the College of American Pathologists (CAP) and the Clinical Lab Improvement Act (CLIA), and limited recourses. Our focus is to provide quality assurance and quality control strategies for resource-constrained environments and provide education on RDT limitations.

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A combined strategy for screening a clustered mobile population returning from highly endemic areas for Plasmodium falciparum

Abstract: It was too complex and difficult to catch all parasite carriers in a short period of time among populations with such a complicated situation as that in Shanglin County. A strategy of combing microscopy and RDT for diagnosis is highly recommended.

Cited by 3 publications

References 14 publications

Management of imported malaria cases and healthcare institutions in central China, 2012–2017: application of decision tree analysis

Management of imported malaria cases and healthcare institutions in central China, 2012–2017: application of decision tree analysis

Evaluation of Malaria Standard Microscopy and Rapid Diagnostic Tests for Screening — Southern Tanzania, 2018–2019

Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm

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