Accuracy of Malaria Diagnosis by Microscopy, Rapid Diagnostic Test, and PCR Methods and Evidence of Antimalarial Overprescription in Non-Severe Febrile Patients in Two Tanzanian Hospitals
Accuracy of Malaria Diagnosis by Microscopy, Rapid Diagnostic Test, and PCR Methods and Evidence of Antimalarial Overprescription in Non-Severe Febrile Patients in Two Tanzanian Hospitals
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DOI：
10.4269/ajtmh.2009.80.712
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发表时间：
2009-05-01
影响因子：
3.3
通讯作者：
Ippolito, Giuseppe
中科院分区：
文献类型：
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作者：
Nicastri, Emanuele;Bevilacqua, Nazario;Ippolito, Giuseppe
本研究的目的是评估疟疾的过度/低估和抗疟疾药物的过度/不足处方。2007年2月至3月，从坦桑尼亚两家外围医院就诊的336名非严重发热门诊患者采集了血液样本。在当地进行镜检和快速诊断试验(RDT)，并通过定性聚合酶链式反应(PCR)评价其准确性。测试是在意大利罗马的国家传染病研究所(INMI)进行的。通过聚合酶链式反应，我们在336名患者中发现了26例疟疾病例(7.7%)。镜检准确率为93.5%，RDT准确率为97.6%。过度处方和漏诊率分别为29.3%和30.8%。应考虑现场培训、发热性疾病的临床管理以及偏远地区的疟疾显微镜检查。
The study was aimed to evaluate the malaria over/underdiagnosis and over/underprescription of antimalarial drugs. Between February and March 2007 blood samples were collected from 336 non-severe febrile outpatients attended in two peripheral Tanzanian hospitals. Microscopy and a rapid diagnostic test (RDT) were done locally and the accuracy evaluated by qualitative polymerase chain reaction (PCR) for Plasmodium spp. The testing was performed at National Institute for Infectious Diseases Lazzaro Spallanzani (INMI), Rome, Italy. As a result of PCR, we identified 26 malaria cases out of 336 (7.7%) patients. Microscopy and RDT accuracies were 93.5% and 97.6%, respectively. Overprescription and underdiagnosis rates were 29.3% and 30.8%, respectively. On-field training, clinical management of febrile illness, and malaria microscopy in remote settings should be considered.