Relación costo-efectividad del uso de pruebas rápidas para el diagnóstico de la malaria en la Amazonia peruana

Aguirre, Ángel Martín Rosas; Llanos-Zavalaga, Fernando; Belaunde, Miguel Trelles de

doi:10.1590/s1020-49892009000500001

Cited by 7 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only one published study was conducted in the Amazon Region, which is endemic for malaria [42]. It was demonstrated that in remote areas RDT led to cost-savings for outcomes considered - timely and appropriate treatment, serious malaria cases and deaths averted - when compared to microscopy.…”

Section: Discussionmentioning

confidence: 99%

Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

Oliveira

Gomes

Toscano

2010

Malar J

View full text Add to dashboard Cite

BackgroundIn areas with limited structure in place for microscopy diagnosis, rapid diagnostic tests (RDT) have been demonstrated to be effective.MethodThe cost-effectiveness of the Optimal® and thick smear microscopy was estimated and compared. Data were collected on remote areas of 12 municipalities in the Brazilian Amazon. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, hospitalization records, primary data collected from the municipalities, and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2006. The results were expressed in costs per adequately diagnosed cases in 2006 U.S. dollars. Sensitivity analysis was performed considering key model parameters.ResultsIn the case base scenario, considering 92% and 95% sensitivity for thick smear microscopy to Plasmodium falciparum and Plasmodium vivax, respectively, and 100% specificity for both species, thick smear microscopy is more costly and more effective, with an incremental cost estimated at US$549.9 per adequately diagnosed case. In sensitivity analysis, when sensitivity and specificity of microscopy for P. vivax were 0.90 and 0.98, respectively, and when its sensitivity for P. falciparum was 0.83, the RDT was more cost-effective than microscopy.ConclusionMicroscopy is more cost-effective than OptiMal® in these remote areas if high accuracy of microscopy is maintained in the field. Decision regarding use of rapid tests for diagnosis of malaria in these areas depends on current microscopy accuracy in the field.

show abstract

Section: Discussionmentioning

confidence: 99%

Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

Oliveira

Gomes

Toscano

2010

Malar J

View full text Add to dashboard Cite

show abstract

“…In such conditions RDTs could be useful, providing quick and accurate diagnosis, thereby leading to timely and correct treatment and reducing the severity and economic burden of disease. Besides, use of RDTs in the Peruvian Amazon has been demonstrated to be cost-effective [4].…”

Section: Introductionmentioning

confidence: 99%

Rapid Diagnostic Tests for Malaria Diagnosis in the Peruvian Amazon: Impact of pfhrp2 Gene Deletions and Cross-Reactions

et al. 2012

View full text Add to dashboard Cite

BackgroundIn the Peruvian Amazon, Plasmodium falciparum and Plasmodium vivax malaria are endemic in rural areas, where microscopy is not available. Malaria rapid diagnostic tests (RDTs) provide quick and accurate diagnosis. However, pfhrp2 gene deletions may limit the use of histidine-rich protein-2 (PfHRP2) detecting RDTs. Further, cross-reactions of P. falciparum with P. vivax-specific test lines and vice versa may impair diagnostic specificity.MethodsThirteen RDT products were evaluated on 179 prospectively collected malaria positive samples. Species diagnosis was performed by microscopy and confirmed by PCR. Pfhrp2 gene deletions were assessed by PCR.ResultsSensitivity for P. falciparum diagnosis was lower for PfHRP2 compared to P. falciparum-specific Plasmodium lactate dehydrogenase (Pf-pLDH)- detecting RDTs (71.6% vs. 98.7%, p<0.001). Most (19/21) false negative PfHRP2 results were associated with pfhrp2 gene deletions (25.7% of 74 P. falciparum samples). Diagnostic sensitivity for P. vivax (101 samples) was excellent, except for two products. In 10/12 P. vivax-detecting RDT products, cross-reactions with the PfHRP2 or Pf-pLDH line occurred at a median frequency of 2.5% (range 0%–10.9%) of P. vivax samples assessed. In two RDT products, two and one P. falciparum samples respectively cross-reacted with the Pv-pLDH line. Two Pf-pLDH/pan-pLDH-detecting RDTs showed excellent sensitivity with few (1.0%) cross-reactions but showed faint Pf-pLDH lines in 24.7% and 38.9% of P. falciparum samples.ConclusionPfHRP2-detecting RDTs are not suitable in the Peruvian Amazon due to pfhrp2 gene deletions. Two Pf-pLDH-detecting RDTs performed excellently and are promising RDTs for this region although faint test lines are of concern.

show abstract

“…El sistema de salud peruano sigue utilizando la microscopía óptica como prueba de referencia para el seguimiento de los pacientes con diagnóstico de malaria; sin embargo, se sabe que este método tiene varias limitaciones, entre ellas, la necesidad de contar con personal entrenado en la lectura microscópica de las muestras, el tiempo requerido para hacer la lectura microscópica y la buena preparación de las muestras para asegurar resultados de calidad (8).…”

Section: Discussionunclassified

“…Esta prueba tiene una sensibilidad del 100 % (IC 95% 99,23-100), una especificidad del 97,14 % (IC 95% 90,10-100) (6), y es sencilla y barata (13,88 soles, aproximadamente 3,50 dólares) (7). Sin embargo, requiere de equipamiento microscópico y personal capacitado que realice la lectura de las muestras (8,9). Todo esto hace que su implementación en lugares de difícil acceso sea poco rentable (9).…”

unclassified

Evaluación de la efectividad de la prueba rápida OptiMAL-IT™ para el seguimiento de pacientes con diagnóstico de malaria en la Amazonía peruana

2022

View full text Add to dashboard Cite

Introducción. En Perú, la microscopía óptica con gota gruesa continúa utilizándose en el seguimiento de los pacientes con malaria o paludismo. Esta prueba es sencilla, pero requiere de equipamiento microscópico y personal idóneo que realice la lectura de las muestras. Los estudios sugieren que la prueba rápida OptiMAL-IT™ es una opción para dicho seguimiento.Objetivo. Evaluar la efectividad de OptiMAL-IT™ como test de seguimiento en pacientes con malaria en áreas endémicas del Perú.Materiales y métodos. Se hizo un estudio observacional, transversal y analítico de pruebas diagnósticas en pacientes con malaria. Se seleccionó a todos los pacientes que cumplían con los criterios de inclusión, procedentes de diferentes establecimientos de salud de los departamentos peruanos de San Martín y Loreto. El diagnóstico se hizo mediante microscopía óptica con gota gruesa y la prueba rápida de diagnóstico inmunocromatográfico OptiMAL-IT™ en los días 2, 3, 7 y 14 para Plasmodium vivax y hasta el día 21 de seguimiento para Plasmodium falciparum. Se calculó el porcentaje de los correctamente clasificados y los valores predictivos, y se compararon los resultados de la selva occidental y la selva oriental mediante ji al cuadrado o prueba exacta de Fisher. Resultados. Se registraron 262 pacientes de San Martín y 302 de Loreto. Los porcentajes correctamente clasificados y el valor predictivo negativo fueron superiores a 92,0 y 93,0 %, respectivamente, a partir del tercer día de seguimiento; no se encontraron diferencias estadísticas en los resultados obtenidos en la Amazonía occidental y los de la oriental. Conclusiones. La prueba OptiMAL-IT™ sería efectiva como test de seguimiento en los pacientes con diagnóstico de malaria en áreas endémicas del Perú.

show abstract

Relación costo-efectividad del uso de pruebas rápidas para el diagnóstico de la malaria en la Amazonia peruana

Cited by 7 publications

References 14 publications

Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

Rapid Diagnostic Tests for Malaria Diagnosis in the Peruvian Amazon: Impact of pfhrp2 Gene Deletions and Cross-Reactions

Evaluación de la efectividad de la prueba rápida OptiMAL-IT™ para el seguimiento de pacientes con diagnóstico de malaria en la Amazonía peruana

Contact Info

Product

Resources

About