Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic.

Details

Ressource 1Download: Berthod_MalarJ_2017.pdf (872.35 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_9904174AFEEA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic.
Journal
Malaria journal
Author(s)
Berthod D., Rochat J., Voumard R., Rochat L., Genton B., D'Acremont V.
ISSN
1475-2875 (Electronic)
ISSN-L
1475-2875
Publication state
Published
Issued date
28/10/2017
Peer-reviewed
Oui
Volume
16
Number
1
Pages
436
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
The WHO recommends that all suspect malaria cases be tested before receiving treatment. Rapid diagnostic tests (RDT) for malaria can be performed reliably by community health workers with no formal medical background and thus, RDTs could also be provided to travellers for self-diagnosis during visits to endemic regions.
RDTs were proposed during pre-travel consultations to pre-defined categories of travellers. A training run on their own blood was performed and, if carried out correctly, the traveller was given a written procedure on how to perform the test and act on its result. The travellers were then proposed to buy a malaria RDT kit and were interviewed upon their return.
From February 2012 to February 2017, 744 travellers were proposed RDTs and 692 performed the training run (one could not complete it due to a hand tremor). Among the 691 subjects included, 69% travelled to moderate- or low-risk areas of malaria, 18% to high-risk areas and 13% to mixed-risk areas. The two most frequent categories of travellers to whom RDTs were proposed were long-term travellers (69%) and those travelling to remote areas (57%). 543 travellers (79%) were interviewed upon return. During their trip, 17% (91/543) had a medical problem with fever and 12% (65/543) without fever. Among 91 febrile patients, 57% (52/91) performed an RDT, 22% (20/91) consulted immediately without using the test, and 21% (19/91) did neither. Four RDTs (4/52; 8%) were positive: 2 in low-risk and 2 in high-risk areas (0.7% attack rate of self-documented malaria). Two travellers could not perform the test correctly and attended a facility or took standby emergency treatment. Four travellers with negative results repeated the test after 24 h; all were still negative. Carrying RDTs made travellers feel more secure, especially when travelling with children.
1/6 travellers experienced fever and 4/5 of those reacted appropriately: more than half used RDTs and a quarter consulted immediately. Four travellers (including 2 from low-risk areas) diagnosed themselves with malaria and self-treated successfully. This strategy allows prompt treatment for malaria in high-risk groups and may avoid over-diagnosis (and subsequent inappropriate treatment) of malaria on-site.
Keywords
Adolescent, Adult, Aged, Ambulatory Care Facilities, Child, Child, Preschool, Cohort Studies, Diagnostic Tests, Routine/instrumentation, Female, Humans, Infant, Malaria/diagnosis, Male, Middle Aged, Reagent Kits, Diagnostic/utilization, Self Care/methods, Switzerland, Young Adult, Malaria rapid diagnostic test, Self-diagnosis, Training run, Traveller
Pubmed
Web of science
Open Access
Yes
Create date
06/11/2017 14:02
Last modification date
20/08/2019 15:00
Usage data