Multi-method assessment of patients with febrile illness reveals over-diagnosis of malaria in rural Uganda

by Ria R. Ghai, Mary I. Thurber, Azza El Bakry et al.
Malaria Journal, 2016 15:460 – Published: 7 September 2016

6 pp. 944 kB
http://malariajournal.biomedcentral.com/track/pdf/10.1186/s12936-016-1502-4?
site=malariajournal.biomedcentral.com
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This study evaluated the rate of malaria misdiagnosis and the accuracy of rapid diagnostic tests (RDTs) in rural Uganda, where presumptive diagnosis still predominates. Specifically, the diagnostic accuracy of “gold standard” methods, microscopy and PCR, were compared to the most feasible method, RDTs. Results suggest that diagnosis of malaria based on symptoms alone appears to be highly inaccurate in this setting. Furthermore, RDTs were very effective at diagnosing malaria, performing as well or better than microscopy. However, only PCR and DNA sequencing detected non-P. falciparum species, which highlights an important limitation of this test and a treatment concern for non-falciparum malaria patients. Nevertheless, RDTs appear the only feasible method in rural or resource-limited areas, and therefore offer the best way forward in malaria management in endemic countries.

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