14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 29.003 Session: Malaria & Blood-borne Parasites Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Performance of four rapid diagnostic tests for diagnosis of falciparum and non-falciparum malaria in endemic areas of Gondar region, Northern Ethiopia A. K. Gelaglie Addis Ababa University, Medical Faculty, Addis Ababa, Ethiopia Background: Malaria remains a major public health problem in Ethiopia, despite decades of a sustained national control program. One of the major obstacles to this control program is the lack of accurate and rapid diagnostic service in most resource poor settings where malaria is endemic. Very recently, efforts have been made to develop and implement various formats of malaria RDTs. Methods: In view of this, the performance of the OptiMAL-IT, Paracheck-Pf, CareStartTM malaria pLDH 4 line test and CareStartTM malaria pLDH/HRP II combo test were investigated in comparison with microscopic examination of thick and thin blood film in malaria endemic areas of Gondar region. In order to evaluate these assays, the sensitivity, specificity, PPV and NPV values of each RDT were calculated taking microscopy results as the gold standard in a total of 588 febrile patients. Results: Paracheck-Pf was the most sensitive (100%) assay for the diagnosis of P. falciparum in comparison with OptiMAL-IT (98.1%), CareStartTM malaria pLDH 4 line test (98.1%) and CareStartTM malaria pLDH/HRP II combo test (96.2%). However, OptiMAL-IT was the most specific (99.1%) as compared to Paracheck-Pf (97.9%), CareStartTM malaria pLDH/HRP II combo test (96.4%) and CareStartTM malaria pLDH 4 line test (93.8%) for falciparum malaria diagnosis. For the diagnosis of P. vivax, both CareStartTM assays had better sensitivity (94.4% for CareStartTM malaria pLDH 4 line test and 94.2% for CareStartTMTMTM malaria pLDH/HRP II combo test (97.9%). malaria pLDH/HRP II combo test) as compared to OptiMAL-IT 88.2%. But OptiMAL-IT gave the higher specificity (99.8%) than CareStart malaria pLDH 4 line test (98.1%) and CareStart Conclusion: Although microscopy remains the gold standard for malaria diagnosis, OptiMAL-IT, Paracheck-Pf, CareStartTM malaria pLDH/HRP II combo test and CareStartTM malaria pLDH 4 line test may prove a useful screening for malaria control in Ethiopia where microscopic examination is not in place. Finally, further studies on RDT performance is recommended to be undertaken in multisite study fields, in monitoring drug therapy and with respect to molecular analysis.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 29.004 Session: Malaria & Blood-borne Parasites Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Clinical presentation and outcome of severe falciparum malaria in Eastern Nepal S. K. Sharma 1 , B. Khanal 1 , D. Manandhar 2 , S. Rijal 1 1 BP Koirala Institute of Health Sciences, Dharan, Nepal, 2 Nepal Medical college, Kathmandu, Nepal Background: Malaria is endemic in 65 out of 75 districts of Nepal and >70% of the total population are at risk of the disease. The clinical presentations of severe and complicated malaria vary. Methods: Clinical profile, biochemical parameters and outcome in 138 adult patients of malaria requiring hospital admission in BP Koirala Institute of Health Sciences hospital, a tertiary care hospital in eastern Nepal during April 2002 to April 2005 were studied. Results: Mean age of the patients was 33 ±16 yrs with majority (n=88) being in age group of 15 to 34 years. 67% of the patients were from terai belt (southern plain area). Mean duration of febrile illness was 13±9 days at the time of presentation and 54% patients had recent history of travel to India. Hepatic dysfunction (39%), anemia (30%), hypotension (18%), metabolic acidosis (16%), convulsion (11%), hypoglycemia (8%) and 22% (n=30) had acute renal failure according to WHO criteria. Three or more complication was present in 32%. Apart from antimalarial therapy, dialysis support and mechanical ventilation was provided to 22 and 25 patients respectively. All the patients who died (23%) had 3 complications. Conclusion: Death from complicated malaria is high. Delayed in diagnosis leading to multiple complications might have contributed to high mortality.
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