Malaria: how useful are clinical criteria for improving the diagnosis in a highly endemic area?

Details

Serval ID
serval:BIB_4E3F49D8999E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Malaria: how useful are clinical criteria for improving the diagnosis in a highly endemic area?
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiène
Author(s)
Genton  B., Smith  T., Baea  K., Narara  A., al-Yaman  F., Beck  H. P., Hii  J., Alpers  M.
ISSN
0035-9203 (Print)
Publication state
Published
Issued date
10/1994
Volume
88
Number
5
Pages
537-41
Notes
Journal Article
Research Support, U.S. Gov't, Non-P.H.S. --- Old month value: Sep-Oct
Abstract
To assess the validity of clinical criteria, we investigated 2096 outpatients diagnosed as malaria cases by nurses at a rural health subcentre in a highly endemic area of Papua New Guinea. 73% of the children < 10 years old had a positive blood slide for any species of Plasmodium and 32% had > or = 10,000 P. falciparum parasites per microL. For adults the frequencies were 51% and 9%, respectively. Stepwise logistic regression identified spleen size, no cough, temperature, no chest indrawing, and normal stools as significant predictors for a positive blood slide in children; no cough and normal stools predicted a positive blood slide in adults. Fever, no cough, vomiting, and enlarged spleen were significant predictors for a P. falciparum parasitaemia > or = 10,000/microL in children; in adults the only predictor was vomiting. In children the association of no cough and enlarged spleen had the best predictive value for a positive blood slide, and a temperature > or = 38 degrees C had the best predictive value for a P. falciparum parasitaemia > or = 10,000 microL. In adults, no major symptom had a good predictive value for a positive blood slide but vomiting had the best predictive value for a P. falciparum parasitaemia > or = 10,000/microL. When microscopy is not available, these findings can help in areas of high endemicity to determine which patients with a history of fever are most likely to have malaria and, more importantly, for which patients another diagnosis should be strongly considered.
Keywords
Adolescent Adult Child Child, Preschool Female Fever/etiology Humans Infant Logistic Models Malaria/*diagnosis/parasitology Malaria, Falciparum/epidemiology Male Papua New Guinea Predictive Value of Tests Splenomegaly
Pubmed
Web of science
Create date
28/01/2008 11:48
Last modification date
20/08/2019 14:03
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