ACCURACY OF MALARIA DIAGNOSIS AND PRESCRIBING PATTERNS FOR FEBRILE UNDERFIVES IN AN AREA WITH DECLINING MALARIA BURDEN, NORTHEASTERN TANZANIA
Journal Title: Asian J of Pharm Sci & Tech - Year 2016, Vol 6, Issue 1
Abstract
ABSTRACT This study examined the accuracy of clinical diagnosis and rapid malaria diagnostic test (mRDT) for the prediction of malaria; and the patterns of prescription for febrile underfives in a setting with reduced malaria burden. A quantitative facility based study was carried among 510 febrile underfives attending in primary health facilities of Tanga city. For each underfives referred for laboratory malaria confirmation; fever was measured by a digital thermometer and finger prick blood samples taken for mRDT testing and microscopy. Results of mRDT were provided to the clinician for a prescription and type of drugs prescribed recorded. Accuracy of measured fever, clinical diagnosis and mRDT for the prediction of malaria was assessed by performance indices against microscopy. Influence of mRDT results on prescribing patterns was also assessed. A clinical malaria diagnosis had a very highly sensitivity (100% [95%CI: 87.0 – 100.0]) and negative predictive value (100.0% [95%CI: 98.7 – 100.0]); but a relatively low specificity (74.0% [95%CI: 70.0 – 77.8]) and very low positive predictive value (21.0% [95%CI: 15.1 – 28.4]). The mRDT retained very high sensitivity ≥ 95.0% (97.0% [95%CI: 84.2 – 99.5]), specificity was also high (93.9 % [95%CI: 91.4 – 95.9]) but below the WHO recommendation of ≥ 95%. Of the 162 receiving antimalarial, only 21.6% were mRDT positive while majority (78.4%) was mRDT negative. Of those receiving antibiotic, the large majority (93.0%) was mRDT negative probably representing an over prescription of antibiotics. The decline in malaria prevalence has altered the performance of mRDT to a specificity < 95% below the WHO recommendation. There was an over prescription of both antimalarial and antibiotics. Key words: Febrile underfives, Diagnostic accuracy, mRDT, Prescribing patterns, Tanzania.
Authors and Affiliations
Donath Samuel Tarimo, Dominic Emilio Shauri, Ahmed Abade Mohamed
Keywords
Related Articles
- EP ID EP144096
- DOI -
- Views 125
- Downloads 0
MICROBIAL CONVERSION OF SUGAR CANE PHYTOSTEROLS BY FUSARIUM SOLANI
ABSTRACT Air dried press cake of sugar cane (5 Kg) yielded on extraction with cold acetone 500 g of waxy residue which gave on saponification 150gm. Un-saponifiable matter. Gas chromatography and mass spectroscop...
BIOANALYTICAL METHOD FOR THE QUANTITATIVE ESTIMATION OF FROVATRIPTAN IN RABBIT PLASMA BY LC–MS/MS AND ITS APPLICATION TO A PHARMACOKINETIC STUDY
ABSTRACT Liquid chromatography–tandem mass spectrometry was used to develop a simple, sensitive and rapid method for the quantitative determination of frovatriptan in rabbit plasma using frovatriptan d3 as intern...
ETHNOMEDICINAL SURVEY OF YAVATMAL DISTRICT (MS)
ABSTRACT Yavatmal District is rich in ethnomedicinal plants. The present paper deals with study of plants used for ethnomedicinal purposes. The ethnomedicinal data of 50 plants species belonging to 33 families we...
ANTIFUNGAL ACTIVITY OF HERBAL EXTRACTS AGAINST NEEM DIE-BACK PATHOGEN PHOMOPSIS AZADIRACHTAE
ABSTRACT Herbal extracts of 26 plants belonging to 20 different families of the plant kingdom were evaluated for antifungal activity against Phomopsis azadirachtae, a fungus causing destructive die-back disease i...