scholarly journals Beyond ‘test and treat’ – malaria diagnosis for improved pediatric fever management in sub-Saharan Africa

2016 ◽  
Vol 9 (1) ◽  
pp. 31744 ◽  
Author(s):  
Emily White Johansson
Keyword(s):  
Malaria Diagnosis ◽  
Sub Saharan Africa ◽  
Test And Treat ◽  
Sub Saharan ◽  
Fever Management

scholarly journals Where are the positives? HIV testing in sub-Saharan Africa in the era of test and treat

AIDS ◽  
2019 ◽  
Vol 33 (2) ◽  
pp. 349-352 ◽  
Author(s):  
Kevin M. De Cock ◽  
Joseph L. Barker ◽  
Rachel Baggaley ◽  
Wafaa M. El Sadr
Keyword(s):  
Hiv Testing ◽  
Sub Saharan Africa ◽  
Test And Treat ◽  
Sub Saharan

scholarly journals Malaria and risk of lymphoid neoplasms and other cancer: a nationwide population-based cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Katja Wyss ◽  
Fredrik Granath ◽  
Andreas Wångdahl ◽  
Therese Djärv ◽  
Michael Fored ◽  
...  
Keyword(s):  
Cox Regression ◽  
Health Agency ◽  
Malaria Diagnosis ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Lymphoid Neoplasms ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Malaria is associated with Burkitt lymphoma among children in Sub-Saharan Africa. No longitudinal studies have assessed the long-term risk of other lymphoma or cancer overall. Here, we investigated the risk of lymphoid neoplasms and other cancer after malaria. Methods We included 4125 patients diagnosed with malaria in Sweden in 1987–2015, identified either through the National Surveillance Database at the Public Health Agency of Sweden, the National Inpatient and Outpatient Register, or by reports from microbiology departments. A comparator cohort (N = 66,997) matched on sex, age and birth region was retrieved from the general population and an additional cohort with all individuals born in Sub-Saharan Africa registered in the Total Population Register in 1987–2015 (N = 171,756). Incident lymphomas and other cancers were identified through linkage with the Swedish Cancer Register. Hazard ratios (HRs) were assessed using Cox regression with attained age as the timescale. Results A total of 20 lymphoid neoplasms and 202 non-haematological cancers were identified among malaria patients during a mean follow-up of 13.3 and 13.7 years, respectively. The overall risk of lymphoid neoplasms was not significantly increased (hazard ratio [HR] 1.24, 95% confidence interval [CI] 0.79–1.94), neither did we find any association with all-site non-haematological cancer (HR 0.89, 95% CI 0.77–1.02). However, in the Sub-Saharan Africa cohort, we observed an increased risk of lymphoid neoplasms after malaria diagnosis (HR 2.39, 95% CI 1.06–5.40), but no difference in the risk of other cancer (HR 1.01, 95% CI 0.70–1.45). The association could not be explained by co-infection with HIV or chronic hepatitis B or C, since the risk estimate was largely unchanged after excluding patients with these comorbidities (HR 2.63, 95% CI 1.08–6.42). The risk became more pronounced when restricting analyses to only including non-Hodgkin and Hodgkin lymphomas (HR 3.49, 95% CI 1.42–8.56). Conclusion Individuals born in malaria-endemic areas and diagnosed with malaria in Sweden had an increased risk of lymphoid neoplasms, especially B cell lymphoma. There was no association with cancer overall nor did single malaria episodes confer an increased risk in travellers.

scholarly journals Modelling the drivers of the spread of Plasmodium falciparum hrp2 gene deletions in sub-Saharan Africa

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Oliver J Watson ◽  
Hannah C Slater ◽  
Robert Verity ◽  
Jonathan B Parr ◽  
Melchior K Mwandagalirwa ◽  
...  
Keyword(s):  
Democratic Republic Of Congo ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Parasite Prevalence ◽  
Malaria Prevalence ◽  
Sub Saharan Africa ◽  
Gene Deletions ◽  
High Frequencies ◽  
Sub Saharan ◽  
Selection Of

Rapid diagnostic tests (RDTs) have transformed malaria diagnosis. The most prevalent P. falciparum RDTs detect histidine-rich protein 2 (PfHRP2). However, pfhrp2 gene deletions yielding false-negative RDTs, first reported in South America in 2010, have been confirmed in Africa and Asia. We developed a mathematical model to explore the potential for RDT-led diagnosis to drive selection of pfhrp2-deleted parasites. Low malaria prevalence and high frequencies of people seeking treatment resulted in the greatest selection pressure. Calibrating our model against confirmed pfhrp2-deletions in the Democratic Republic of Congo, we estimate a starting frequency of 6% pfhrp2-deletion prior to RDT introduction. Furthermore, the patterns observed necessitate a degree of selection driven by the introduction of PfHRP2-based RDT-guided treatment. Combining this with parasite prevalence and treatment coverage estimates, we map the model-predicted spread of pfhrp2-deletion, and identify the geographic regions in which surveillance for pfhrp2-deletion should be prioritised.

scholarly journals Anaemia and severe malarial anaemia burden in febrile Gabonese children: a nine-year health facility based survey

2013 ◽  
Vol 7 (12) ◽  
pp. 983-989 ◽  
Author(s):  
Marielle Karine Bouyou-Akotet ◽  
Denise Patricia Mawili Mboumba ◽  
Eric Kendjo ◽  
Fanckie Mbadinga ◽  
Nestor Obiang-Bekale ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Diagnosis ◽  
Malaria Prevalence ◽  
Severe Anaemia ◽  
Falciparum Infection ◽  
Sub Saharan Africa ◽  
Nutritional Deficiencies ◽  
Infection Prevalence ◽  
Severe Malarial Anaemia ◽  
Sub Saharan

Introduction: Anaemia remains a major cause of poor health in children and pregnant women living in sub-Saharan Africa. Malaria is one of the main causes of anaemia in endemic countries. At the time of decreasing Plasmodium falciparum infection prevalence among children, it was essential to analyze the evolution of anaemia and severe malarial anaemia (SMA), the most frequent clinical manifestation of severe malaria, in Gabon. Methodology: Yearly recorded haemoglobin levels of febrile children aged below11 years, who benefitted from microscopic malaria diagnosis, were retrospectively analyzed to determine the evolution of anaemia and SMA prevalence throughout a nine-year period between 2000 and 2008. Results: Anaemia prevalence remained high both in P. falciparum-infected children (between 87.6% and 90.7%) and in uninfected children (between 73.5% and 82.6%). Although the risk of developing severe anaemia ranged between 1.9 [0.9-3.8] in 2000 and 3.0 [1.3-6.5] in 2007, SMA prevalence did not significantly change during the study period, varying from 6.0% to 8.0%. From 2001, the frequency of SMA was comparable between children younger than five years of age and children older than five years of age. Conclusions: The decreasing malaria prevalence previously observed in Gabon between 2000 and 2008 was not associated with a significant reduction of anaemia and SMA burden among children. Furthermore, other factors such as nutritional deficiencies, which may not be negligible, must be investigated in this vulnerable population

scholarly journals Diagnostic Performance of Blood Film Microscopy and PfHRP2-based RDT in a Routine Clinical Setting of a Secondary Health Facility in Ghana

2019 ◽  
pp. 1-9
Author(s):  
Francis O. Agyapong ◽  
Daniel Ansong ◽  
Alex Owusu-Ofori ◽  
Ruby Martin-Peprah
Keyword(s):  
Diagnostic Performance ◽  
Malaria Diagnosis ◽  
Blood Film ◽  
Molecular Techniques ◽  
Sub Saharan Africa ◽  
Reference Test ◽  
Paediatric Age ◽  
Sub Saharan ◽  
Low Sensitivity ◽  
High Level

Background: Malaria remains a major public health threat claiming many lives particularly in Sub-Saharan Africa. Light microscopy and RDT are the mainstay tests in the clinical settings for malaria diagnosis. Many studies report varying levels of validity of these tests compared to molecular methods like PCR. Documentation on such comparative study involving the use of molecular techniques as reference test is scanty in Ghana. This study therefore assesses the diagnostic performance of these tests compared to PCR. Methods: Blood film microscopy (thin and thick), RDT and nested PCR were run on blood samples from a total of 188 malaria suspected patients. The accuracy indices of the microscopy and RDT were calculated using the results of the PCR as the reference test. Results: A total of 188 patients were recruited with females constituting the majority 128 (68%). The paediatric age group 1-10 years carried the largest burden of malaria by means of all the 3 tests. A sensitivity of 47.37% (95% ci, 37.03 – 57.88%) was shown by both the microscopy and RDT with specificity of 93.55% (95% ci, 86.48 – 97.60) and 100% (95% ci, 96.11 – 100.00%) and kappa co – efficient of 0.41 and 0.47 respectively. Conclusion: Both microscopy and RDT exhibited high level of specificity but low sensitivity. Significant number of malaria parasitaemic patients as revealed by the PCR was missed by both the RDT and blood film microscopy and thus went undiagnosed.

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