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Diagnostic Performance of Plasmodium falciparum Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso). Trop Med Infect Dis 2022; 7:tropicalmed7120440. [PMID: 36548695 PMCID: PMC9784090 DOI: 10.3390/tropicalmed7120440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Malaria control has strongly benefited from the implementation of rapid diagnostic tests (RDTs). The malaria RDTs used in Burkina Faso, as per the recommendation of the National Malaria Control Program, are based on the detection of histidine-rich protein-2 (PfHRP2) specific to Plasmodium falciparum, which is the principal plasmodial species causing malaria in Burkina Faso. However, there is increasing concern about the diagnostic performance of these RDTs in field situations, and so constant monitoring of their accuracy is warranted. (2) Methods: A prospective study was performed in the health district of Nanoro, where 391 febrile children under 5 years with an axillary temperature ≥37.5 °C presenting at participating health facilities were subjected to testing for malaria. The HRP2-based RDT and expert microscopy were used to determine the diagnostic performance of the former. Retrospectively, the correctness of the antimalaria prescriptions was reviewed. (3) Results: Taking expert malaria microscopy as the gold standard, the sensitivity of the employed RDT was 98.5% and the specificity 40.5%, with a moderate agreement between the RDT testing and microscopy. In total, 21.7% of cases received an inappropriate antimalarial treatment based on a retrospective assessment with expert microscopy results. (4) Conclusion: Malaria remains one of the principal causes of febrile illness in Burkina Faso. Testing with HRP2-based RDTs is inaccurate, in particular, due to the low specificity, which results in an over-prescription of antimalarials, with emerging antimalarial drug resistance as an important risk and many children not being treated for potential other causes of fever.
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Phase 3 Evaluation of an Innovative Simple Molecular Test for the Diagnosis of Malaria and Follow-Up of Treatment Efficacy in Pregnant Women in Sub-Saharan Africa (Preg-Diagmal). Trop Med Infect Dis 2022; 7:tropicalmed7090219. [PMID: 36136630 PMCID: PMC9501078 DOI: 10.3390/tropicalmed7090219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
The malaria parasite Plasmodium falciparum (Pf) can sequester in the placenta resulting in low density of peripheral parasitemia and consequently in false negative malaria diagnosis (by microscopy) in pregnant women. Moreover, the use of rapid diagnostic tests (RDTs) in diagnostic strategies, including those for the detection of a malaria infection during pregnancy, is constrained by either persistent malaria antigen (histidine-rich protein 2; HRP2) after successful treatment, leading to false positive test results, or by false negative results as previously mentioned due to parasite sequestration (which is further exacerbated due to the low limited of detection [LoD] of conventional RDTs) or to HRP2 deletion. Recently, a direct blood polymerase chain reaction combined with a nucleic acid lateral flow immunoassay (dbPCR-NALFIA) has been developed, which circumvents these challenges and has demonstrated its diagnostic potential in phase 1 and 2 studies. The PREG-DIAGMAL trial presented in this manuscript will assess the diagnostic performance of dbPCR-NALFIA for the diagnostic of malaria in pregnant women and its potential to monitor treatment efficacy in these subjects. The work is ancillary embedded in an ongoing EDCTP funded trial, the PyraPreg project (PACTR202011812241529) in which the safety and efficacy of a newly registered Artemisinin-Based Combination (Pyronaridine-Artesunate) is being evaluated in pregnant women. This is a Phase 3 diagnostic evaluation conducted in 2 African countries: Democratic Republic of the Congo (DRC) and Burkina Faso. Pregnant women fulfilling the inclusion criteria of the PyraPreg study will be also invited to participate in the PREG-DIAGMAL study. Diagnostic accuracy will be assessed following the WHO/TDR guidelines for the evaluation of diagnostics and reported according to STARD principles. Due to the lack of a 100% specific and sensitive standard diagnostic test for malaria, the sensitivity and specificity of the new test will be compared to the available diagnostic practice in place at the selected settings (microscopy and/or RDT) and to quantitative PCR as the reference test. This phase 3 diagnostic study is designed towards the evaluation of the performance of a new diagnostic tool for the screening of malaria and the monitoring of treatment in pregnant women under real conditions life. If successful, the dbPCR-NALFIA could be a valuable tool to add to the diagnostic arsenal for malaria, in particular during pregnancy. Trial registration: Pan African Clinical Trial Registry database (PACTR202203780981413). Registered on 17 March 2022.
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Kiemde F, Tinto H, Carter J, Rouamba T, Valia D, Conteh L, Sicuri E, Simmons B, Nour B, Mumbengegwi D, Hailu A, Munene S, Talha A, Aemero M, Meakin P, Paulussen R, Page S, Dijk NV, Mens P, Schallig H. Phase 3 evaluation of an innovative simple molecular test for the diagnosis of malaria in different endemic and health settings in sub-Saharan Africa (DIAGMAL). PLoS One 2022; 17:e0272847. [PMID: 36048775 PMCID: PMC9436057 DOI: 10.1371/journal.pone.0272847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/27/2022] [Indexed: 11/19/2022] Open
Abstract
Background Rapid Diagnostic Tests (RDTs) have become the cornerstone for the management of malaria in many endemic settings, but their use is constrained for several reasons: (i) persistent malaria antigen (histidine-rich protein 2; HRP2) leading to false positive test results; (ii) hrp2 deletions leading to false negative PfHRP2 results; and (iii) limited sensitivity with a detection threshold of around 100 parasites/μl blood (pLDH- and HRP2-based) leading to false negative tests. Microscopy is still the gold standard for malaria diagnosis, and allows for species determination and quantitation, but requires trained microscopists, maintained microscopes and has detection limit issues. Consequently, there is a pressing need to develop and evaluate more sensitive and accurate diagnostic tests. To address this need we have developed a direct on blood mini PCR-NALFIA test that combines the benefits of molecular biology with low infrastructural requirements and extensive training. Methods This is a Phase 3 diagnostic evaluation in 5 African countries. Study sites (Sudan, Ethiopia, Burkina, Kenya and Namibia) were selected to ensure wide geographical coverage of Africa and to address various malaria epidemiological contexts ranging from high transmission to near elimination settings with different clinical scenarios and diagnostic challenges. Study participants will be enrolled at the study health facilities after obtaining written informed consent. Diagnostic accuracy will be assessed following the WHO/TDR guidelines for the evaluation of diagnostics and reported according to STARD principles. Due to the lack of a 100% specific and sensitive standard diagnostic test for malaria, the sensitivity and specificity of the new test will be compared to the available diagnostic practices in place at the selected sites and to quantitative PCR as the reference test. Discussion This phase 3 study is designed to validate the clinical performance and feasibility of implementing a new diagnostic tool for the detection of malaria in real clinical settings. If successful, the proposed technology will improve the diagnosis of malaria. Enrolment started in November 2022 (Kenya) with assessment of long term outcome to be completed by 2023 at all recruitment sites. Trial registration Pan African Clinical Trial Registry (www.pactr.org) PACTR202202766889963 on 01/02/2022 and ISCRTN (www.isrctn.com/) ISRCTN13334317 on 22/02/2022.
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Affiliation(s)
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | | | | | - Daniel Valia
- Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Lesong Conteh
- London School of Economics and Political Science, London, United Kingdom
| | - Elisa Sicuri
- London School of Economics and Political Science, London, United Kingdom
- ISGlobal, Barcelona, Spain
| | - Bryony Simmons
- London School of Economics and Political Science, London, United Kingdom
| | - Bakri Nour
- Blue Nile National Institute for Communicable Diseases, University of Gezira, Wad Medani, Sudan
| | | | - Asrat Hailu
- University of Addis Ababa, Addis Ababa, Ethiopia
| | | | | | | | - Paul Meakin
- Innova Partnerships, St Fillans, United Kingdom
| | | | | | - Norbert van Dijk
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam, The Netherlands
- Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
| | - Petra Mens
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam, The Netherlands
- Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
| | - Henk Schallig
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam, The Netherlands
- Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
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Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm. Diagnostics (Basel) 2021; 11:diagnostics11050768. [PMID: 33922917 PMCID: PMC8145891 DOI: 10.3390/diagnostics11050768] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 01/24/2023] Open
Abstract
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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Dejazmach Z, Alemu G, Yimer M, Muluneh C, Tegegne B. Evaluation of the performance of health extension workers on malaria rapid diagnostic tests and predictor factors in Bahir Dar Zuria district, northwest Ethiopia: A cross-sectional study. PLoS One 2021; 16:e0249708. [PMID: 33831059 PMCID: PMC8031431 DOI: 10.1371/journal.pone.0249708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background In Ethiopia, anti-malaria treatment is initiated after parasitological confirmation using blood film microscopy at health centers and hospitals, or serological rapid diagnostic tests at health posts. At health posts, the diagnosis is performed by health extension workers using rapid diagnostic tests after little training. However, there is paucity of data about the health extension workers’ performance on rapid diagnostic tests. Hence, periodic monitoring of the performances of health extension workers on malaria rapid diagnostic tests and predicted factors plays a pivotal role for the control of malaria. Methods A cross sectional study was conducted in May 2020, among 75 health extension workers working at health posts in Bahir Dar Zuria district, Northwest Ethiopia. Their performance on malaria rapid diagnostic tests was assessed by distributing known positive and negative samples as confirmed by investigators using both rapid diagnostic test and blood film microscopy. Test results from health extension workers were then compared with that of investigators. Procedural errors committed while performing the tests were assessed using observational checklist. Data were analyzed using SPSS software version 20. Results The overall sensitivity and specificity of health extension workers in detecting Plasmodium species were 96.8% and 98.7%, respectively with 97.3% result agreement between the health extension workers and investigators (kappa value = 0.949). The most common procedural errors committed by health extension workers was ‘not checking expiry date of the test kits’ followed by ‘not adhering to the appropriate time of reading results’ that 70.7% and 64% of the participants committed these errors, respectively. Total number of procedural errors committed by those who have got in-service training was decreased by 47.3% as compared to those without in-service training. Conclusions Health extension workers had high performance on malaria rapid diagnostic tests. However, in-service training and periodic supervision should be given in order to maximize performance on these tests.
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Affiliation(s)
- Zelalem Dejazmach
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
- * E-mail:
| | - Getaneh Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulat Yimer
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Medical Parasitology, Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Chalachew Muluneh
- Medical Parasitology and Vector Control, Bahir Dar Zuria Woreda Health Office, Bahir Dar, Ethiopia
| | - Banchamlak Tegegne
- Medical Parasitology, Amhara Public Health Institute, Bahir Dar, Ethiopia
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Hu J, Zhang C, Wang S, Chen X, Hu J, Liu X. Accuracy of rapid diagnostic test to diagnose malaria in children under 5 years of age, a meta-analysis. Diagn Microbiol Infect Dis 2021; 100:115351. [PMID: 33743294 DOI: 10.1016/j.diagmicrobio.2021.115351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/07/2021] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess the accuracy of the rapid diagnostic test for malaria diagnosis in children under 5 years of age. METHODS As of August 31, 2020, PubMed, Web of Science and Cochrane Library databases had been systematically searched. Relevant data were extracted and meta-analysis was carried out. A random effects model was used for subgroup analysis. RESULTS According to the inclusion criteria, a total of 26 studies were included in this meta-analysis. The pooled sensitivity and specificity were 0.92 (95% confidence interval 0.83-0.96) and 0.92 (0.86-0.95), the parasite-specific lactate dehydrogenase-based test were 0.96 (0.85-0.98) and 0.93 (0.86-0.95), the histidine-rich protein 2-based test were 0.94 (0.84-0.98) and 0.86 (0.77-0.91). CONCLUSIONS This meta-analysis showed that rapid diagnostic test had good accuracy in diagnosing malaria in children under 5 years of age. And the diagnostic performance of parasite-specific lactate dehydrogenase test was better than that of the histidine-rich protein 2 test.
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Affiliation(s)
- Junjun Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Chenyang Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Song Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiaofei Chen
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jiayi Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin Province, China.
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Zhu W, Ling X, Shang W, Du Y, Liu J, Cao Y, Yang M, Zhu G, Cao J, Huang J. High value of rapid diagnostic tests to diagnose malaria within children: A systematic review and meta-analysis. J Glob Health 2020; 10:010411. [PMID: 32373330 PMCID: PMC7182354 DOI: 10.7189/jogh.10.010411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Children aged under five years accounted for 61% of all malaria deaths worldwide in 2017, and quicker differential diagnosis of malaria fever is vital for them. Rapid diagnostic tests (RDTs) are strips to detect Plasmodium specific antigens promptly and are helpful in resource-limited areas. Thus, our aim is to assess the diagnostic accuracy of RDTs for malaria in children against the gold standard. Methods MEDLINE, Web of Science, EMBASE, Cochrane Library, the China National Knowledge Infrastructure, Wanfang, and Sinomed databases were systematically searched on August 23, 2019. Studies that compared RDTs with microscopy or polymerase chain reaction in malaria diagnoses for children were eligible. Relevant data were extracted. The quality of studies was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies instrument. Meta-analyses were carried out to calculate the pooled estimates and 95% confidence intervals of sensitivity and specificity. Results 51 articles were included. For diagnostic accuracy, the pooled estimates of the sensitivity and specificity of RDTs were 0.93 (95% confidence interval (CI) = 0.90, 0.95) and 0.93 (95% CI = 0.90, 0.96) respectively. Studies were highly heterogeneous, and subgroup analyses showed that the application of RDTs in high malaria transmission areas had higher sensitivity but lower specificity than those in low-to-moderate areas. Conclusions RDTs have high accuracy for malaria diagnosis in children, and this characteristic is more prominent in high transmission areas. As they also have the advantages of rapid-detection, are easy-to-use, and can be cost-effective, it is recommended that the wider usage of RDTs should be promoted, especially in resource-limited areas. Further research is required to assess their performance in WHO South-East Asia and Americas Region.
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Affiliation(s)
- Wenjun Zhu
- Key Lab of Health Technology Assessment, National Health Commission; School of Public Health, Fudan University, Shanghai, China
| | - XiaoXiao Ling
- Department of Statistical Science, University College London, London, UK
| | - Wenru Shang
- Key Lab of Health Technology Assessment, National Health Commission; School of Public Health, Fudan University, Shanghai, China
| | - Yanqiu Du
- Key Lab of Health Technology Assessment, National Health Commission; School of Public Health, Fudan University, Shanghai, China
| | - Jinyu Liu
- Key Lab of Health Technology Assessment, National Health Commission; School of Public Health, Fudan University, Shanghai, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, China
| | - Mengmeng Yang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, Jiangsu, China
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, Jiangsu, China
| | - Jiayan Huang
- Key Lab of Health Technology Assessment, National Health Commission; School of Public Health, Fudan University, Shanghai, China
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Bonko MDA, Kiemde F, Tahita MC, Lompo P, Some AM, Tinto H, van Hensbroek MB, Mens PF, Schallig HDFH. The effect of malaria rapid diagnostic tests results on antimicrobial prescription practices of health care workers in Burkina Faso. Ann Clin Microbiol Antimicrob 2019; 18:5. [PMID: 30691506 PMCID: PMC6348635 DOI: 10.1186/s12941-019-0304-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/20/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Malaria rapid diagnostic tests (RDT) are widely used in endemic areas in order to comply with the recommendation that malaria treatment should only be given after the clinical diagnosis has been confirmed by RDT or microscopy. However, the overestimation of malaria infection with the use of PfHRP2 based RDT, makes the management of febrile illnesses more challenging. This study aimed to assess the effect of the use of malaria RDT on antimicrobial prescription practices. METHODS A prospective study was conducted among febrile children under-5 years of age attending four health facilities and the referral hospital in the Nanoro Health District (Burkina Faso). To assess the effect of malaria RDT testing on the prescriptions of antimicrobials in febrile children, the initial diagnosis and antimicrobial prescriptions following a malaria RDT testing were recorded. The necessity of these prescriptions was subsequently checked by assessing the actual cause of fever by expert malaria microscopy and a microbiology analysis of blood, urine, stool and nasopharynx swabs that were collected from febrile cases to determine the actual cause of the fever episode. RESULTS Malaria was diagnosed by nurses, who are the primary health care providers, with a malaria RDT in 72.7% (798/1098) of febrile children, but only 53.7% (589/1097) cases could be confirmed by expert microscopy. Health care workers were likely to prescribe antimalarials to malaria positive RDT compared to malaria negative RDT (RR = 7.74, p = 0.00001). Malaria negative RDT result had a significant influence on the antibiotic prescriptions (RR = 3.57, p = 0.0001). The risk of prescribing antimicrobials was higher in health facility level compared to referral hospital. By cross-checking of laboratory findings to antimicrobial prescriptions, an important part of children with positive bacterial infection have received antibiotic prescriptions although the majority without any infection have also received antibiotics. CONCLUSION Despite the good attitude of health care workers to adhere to diagnostic test results, antimalarials and antibiotics remain inappropriate prescribed to febrile children. The low specificity of malaria RDT used could be an important cause of these practices.
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Affiliation(s)
- Massa dit Achille Bonko
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
- Parasitology Unit, Department of Medical Microbiology, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Francois Kiemde
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
- Parasitology Unit, Department of Medical Microbiology, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Global Child Health Group, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc Christian Tahita
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Palpouguini Lompo
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Athanase M. Some
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Halidou Tinto
- Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Michael Boele van Hensbroek
- Global Child Health Group, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Petra F. Mens
- Parasitology Unit, Department of Medical Microbiology, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Henk D. F. H. Schallig
- Parasitology Unit, Department of Medical Microbiology, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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