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      Comparison between Microscopy and PfHRP2 based RDT for diagnosing Tropical Malaria in Febrile Patients in Mesoendemic Malaria Transmission Area of Eural Burundi, among Internally Displaced Populations after Tribal Conflicts

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      Clinical Social Work and Health Intervention

      Journal of Clinical Social Work and Health Intervention

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          Quality assurance of rapid diagnostic tests for malaria in routine patient care in rural Tanzania.

          Histidine-rich protein II (HRP2)-based malaria rapid diagnostic tests (RDTs) have shown high sensitivity and specificity for detecting Plasmodium falciparum malaria in a variety of study settings. However, RDTs are susceptible to heat and humidity and variation in individual performance, which may affect their use in field settings. We evaluated sensitivity and specificity of RDTs during routine use for malaria case management in peripheral health facilities. From December 2007 to October 2008, HRP2-based ParaHIT-f RDTs were introduced in 12 facilities without available microscopy in Rufiji District, Tanzania. Health workers received a single day of instruction on how to perform an RDT and thick blood smear. Job aids, Integrated Management of Childhood Illness guidelines, and national malaria treatment algorithms were reviewed. For quality assurance (QA), thick blood smears for reference microscopy were collected for 2 to 3 days per week from patients receiving RDTs; microscopy was not routinely performed at the health facilities. Slides were stained and read centrally within 72 hours of collection by a reference microscopist. When RDT and blood smear results were discordant, blood smears were read by additional reference microscopists blinded to earlier results. Facilities were supervised monthly by the district laboratory supervisor or a member of the study team. Ten thousand six hundred fifty (10,650) patients were tested with RDTs, and 51.5% (5,488/10,650) had a positive test result. Blood smear results were available for 3,914 patients, of whom 40.1% (1,577/3,914) were positive for P. falciparum malaria. Overall RDT sensitivity was 90.7% (range by facility 85.7-96.5%) and specificity was 73.5% (range 50.0-84.3%). Sensitivity increased with increasing parasite density. Successful implementation of RDTs was achieved in peripheral health facilities with adequate training and supervision. Quality assurance is essential to the adequate performance of any laboratory test. Centralized staining and reading of blood smears provided useful monitoring of RDT performance. However, this level of QA may not be sustainable nationwide.
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            Low sensitivity of ParaHIT-f rapid malaria test among patients with fever in rural health centers, Northern Tanzania.

            Several rapid diagnostic tools for malaria are currently available in local markets. However, diagnostic accuracy varies widely. The present study was conducted to evaluate a cheaply and easily available rapid diagnostic malaria test (ParaHIT-f) in rural Tanzania.
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              Knowledge of malaria among women of Burundi and its impact on the incidence of the disease.

              In order to investigate whether the persistently high incidence of malaria in Burundi is due to a lack of knowledge of the disease, mothers of children admitted to the hospital of Kiremba in Burundi were anonymously administered a semi-structured questionnaire about malaria. A total of 539 questionnaires were evaluated. About 75% of the women knew that malaria is transmitted by mosquitoes, and respectively 58.3 and 23.9% knew that it could lead to the death of a fetus or a low birth weight. Fewer than half of the women (44.7%) knew that malaria can be definitely diagnosed by means of a blood examination and only 39.7% indicates that artesunate-amodiaquine was the first-line therapy recommended by the Burundian health authorities. Long-lasting insecticidal or insecticide-treated nets were used by only 33.0%. Burundian women generally know little about malaria. Public awareness programmes should be conducted before any malaria control initiatives are planned.
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                Author and article information

                Journal
                Clinical Social Work and Health Intervention
                CSWHI
                Journal of Clinical Social Work and Health Intervention
                2222386X
                20769741
                July 15 2017
                July 15 2017
                : 8
                : 2
                : 19-25
                Article
                10.22359/cswhi_8_2_04
                © 2017

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                Psychology, Social & Behavioral Sciences

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