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Rapid diagnostic test-based management of malaria : an effectiveness study in Papua New Guinean infants with Plasmodium falciparum and Plasmodium vivax Malaria

Senn, N. and Rarau, P. and Manong, D. and Salib, M. and Siba, P. and Robinson, L. J. and Reeder, J. and Rogerson, S. and Müller, I. and Genton, B.. (2012) Rapid diagnostic test-based management of malaria : an effectiveness study in Papua New Guinean infants with Plasmodium falciparum and Plasmodium vivax Malaria. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 54, H. 5. pp. 644-651.

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Official URL: http://edoc.unibas.ch/dok/A6094335

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Abstract

Background. In malaria-endemic areas it is recommended that febrile children be tested for malaria by rapid diagnostic test (RDT) or blood slide (BS) and receive effective malaria treatment only if results are positive. However, RDTs are known to perform less well for Plasmodium vivax. We evaluated the safety of withholding antimalarial drugs from young Papua New Guinean children with negative RDT results in areas with high levels of both Plasmodium falciparum and P. vivax infections.Methods. longitudinal prospective study of children aged 3-27 months visiting outpatient clinics for fever. RDT was administered at first visit. RDT and microscopy were performed if children returned because of persistent symptoms. Outcomes were rates of reattendance and occurrence of severe illnesses.Results. Of 5670 febrile episodes, 3942 (70%) involved a negative RDT result. In 133 cases (3.4%), the children reattended the clinic within 7 days for fever, of whom 29 (0.7%) were parasitemic by RDT or microscopy. Of children who reattended, 24 (0.7%) presented with a severe illness: 2 had lower respiratory tract infections (LRTIs) with low-density P. vivax on BS; 2 received a diagnosis of P. vivax malaria on the basis of RDT but BSs were negative; 16 had LRTIs; 3 had alternative diagnoses. Of these 24, 22 were cured at day 28. Two children died of illnesses other than malaria and were RDT and BS negative at the initial and subsequent visits.Conclusion. Treatment for malaria based on RDT results is safe and feasible even in infants living in areas with moderate to high endemicity for both P. falciparum and P. vivax infections
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions
UniBasel Contributors:Müller, Ivan and Genton, Blaise and Senn, Nicolas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Oxford University Press
ISSN:1058-4838
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:19 Jul 2013 07:44
Deposited On:19 Jul 2013 07:42

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