Management of fever among under-fives and utility of malaria rapid diagnostic test under reduced malaria burden in Rufii District, Southeastern Tanzania

Journal Title: Asian Pacific Journal of Tropical Disease - Year 2015, Vol 5, Issue 11

Abstract

Objective: To investigate case management of fever among under-fives, performance and utility of malaria rapid diagnostic test (mRDT) under reduced malaria burden in Rufiji District, Southeastern Tanzania. Methods: A quantitative cross sectional study was conducted at primary health facilities in Rufiji District from April to May 2012. Information on socio-demographic characteristics, history and duration of fever, fever measurement, clinical diagnosis and drugs prescribed were recorded. Parasitological malaria confirmation was done by mRDT and microscopy. Performance of mRDT and utility of mRDT results to guide on the management of malarial and non-malarial fevers were assessed. Results: Of the 466 under-fives with fever, 111 (23.8%) were mRDT positive and 100 (21.5%) were microscopically positive for malaria. Sensitivity and specificity of mRDT were 90% [95% confidence interval (CI): 82.6%–94.5%] and 94.3% (95% CI: 91.4%–96.2%) respectively; overall diagnostic accuracy was 93.3% (95% CI: 91.1%–95.6%). A total of 130 (28.5%) underfives received an antimalarial. Among them, 109 (83.8%) were mRDT positive while 21 (16.2%) were negative. Of the 100 under-fives with microscopic parasitaemia, 34 had counts > 200 000/ µL an indication for quinine but only 5/34 (14.7%) received quinine prescription. Five underfives with parasitaemia > 200 000/µL had negative mRDT results. Being mRDT negative was significantly associated with receipt of an antibiotic prescription (χ2 = 162.2, P < 0.001). Conclusions: Use of mRDT reduced unnecessary antimalarial use by 71.5%. However, this had the potential for over prescribing an antibiotic for non-malarial fevers. The diagnostic performance of mRDT was still high despite decline in malaria burden.

Authors and Affiliations

Keywords

Related Articles

Biocontrol efficacy of an organic acid against larval form of Culex quinquefasciatus, Culex vishuni group and Anopheles stephensi

Objective: To estimate the larvicidal activities, if any of glacial acetic acid, an organic acid against Culex quinquefasciatus (Cx. quinquefasciatus), Culex vishuni (Cx. vishuni) group and Anopheles stephensi (An. steph...

Tuberculous mastitis-A great mimicker

Objective: To focus on the increasing incidence of breast tuberculosis, its mistaken identity with carcinoma or pyogenic abscess and its effective diagnosis on cytology. Methods: This retrospective study was carried over...

Serum interferon-gamma and interleukin-4 in patients with brucellosis before and after treatment

Objective: To evaluate serum levels of interferon-gamma (IFN-γ) and interleukin-4 (IL-4) in patients with brucellosis before and after treatment. Methods: In this cross-sectional study 30 patients (18 males and 12 female...

A survey of intestinal parasites in a population in Qazvin, north of Iran

Objective: To study the distribution of intestinal parasites in a population in Qazvin city in north of Iran. Methods: A retrospective cross-sectional study of patients with suspicious intestinal parasitic infections ref...

Isolation of Shigella species and their resistance patterns to a panel of fifteen antibiotics in mid and far western region of Nepal

Objective: To determine the antimicrobial resistance patterns of Shigella species to the most commonly used antibiotics in mid and far western part of Nepal. Methods: Stool samples were collected from 458 patients who ca...

Download PDF file
  • EP ID EP228410
  • DOI 10.1016/S2222-1808(15)60946-X
  • Views 121
  • Downloads 0

How To Cite

(2015). Management of fever among under-fives and utility of malaria rapid diagnostic test under reduced malaria burden in Rufii District, Southeastern Tanzania. Asian Pacific Journal of Tropical Disease, 5(11), 862-868. https://www.europub.co.uk/articles/-A-228410