Rapid diagnostic tests for the home-based management of malaria, in a high-transmission area.

Détails

ID Serval
serval:BIB_29F75F57FA95
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Rapid diagnostic tests for the home-based management of malaria, in a high-transmission area.
Périodique
Annals of Tropical Medicine and Parasitology
Auteur(s)
Willcox Merlin L., Sanogo F., Graz Bertrand, Forster M., Dakouo F., Sidibe Oumar, Falquet Jacques, Giani Sergio, Diakite Chiaka, Diallo D.
ISSN
0003-4983
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
103
Numéro
1
Pages
3-16
Langue
anglais
Résumé
Rapid diagnostic tests (RDT) are sometimes recommended to improve the home-based management of malaria. The accuracy of an RDT for the detection of clinical malaria and the presence of malarial parasites has recently been evaluated in a high-transmission area of southern Mali. During the same study, the cost-effectiveness of a 'test-and-treat' strategy for the home-based management of malaria (based on an artemisinin-combination therapy) was compared with that of a 'treat-all' strategy. Overall, 301 patients, of all ages, each of whom had been considered a presumptive case of uncomplicated malaria by a village healthworker, were checked with a commercial RDT (Paracheck-Pf). The sensitivity, specificity, and positive and negative predictive values of this test, compared with the results of microscopy and two different definitions of clinical malaria, were then determined. The RDT was found to be 82.9% sensitive (with a 95% confidence interval of 78.0%-87.1%) and 78.9% (63.9%-89.7%) specific compared with the detection of parasites by microscopy. In the detection of clinical malaria, it was 95.2% (91.3%-97.6%) sensitive and 57.4% (48.2%-66.2%) specific compared with a general practitioner's diagnosis of the disease, and 100.0% (94.5%-100.0%) sensitive but only 30.2% (24.8%-36.2%) specific when compared against the fulfillment of the World Health Organization's (2003) research criteria for uncomplicated malaria. Among children aged 0-5 years, the cost of the 'test-and-treat' strategy, per episode, was about twice that of the 'treat-all' (U.S.$1.0. v. U.S.$0.5). In older subjects, however, the two strategies were equally costly (approximately U.S.$2/episode). In conclusion, for children aged 0-5 years in a high-transmission area of sub-Saharan Africa, use of the RDT was not cost-effective compared with the presumptive treatment of malaria with an ACT. In older patients, use of the RDT did not reduce costs. The question remains whether either of the strategies investigated can be made affordable for the affected population.
Mots-clé
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Animals, Child, Child, Preschool, Humans, Infant, Malaria/diagnosis, Mali, Middle Aged, Plasmodium/isolation & purification, Predictive Value of Tests, Reagent Kits, Diagnostic/standards, Rural Health, Sensitivity and Specificity, Young Adult
Pubmed
Web of science
Création de la notice
07/01/2010 13:50
Dernière modification de la notice
03/03/2018 15:22
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