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Am. J. Trop. Med. Hyg., 78(2), 2008, pp. 217-221
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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Accuracy and Reliability of Malaria Diagnostic Techniques for Guiding Febrile Outpatient Treatment in Malaria-Endemic Countries

Hanitra Rakotonirina, Céline Barnadas, Rogelin Raherijafy, Hery Andrianantenaina, Arsène Ratsimbasoa, Laurence Randrianasolo, Martial Jahevitra, Valérie Andriantsoanirina, AND Didier Ménard*
Malaria Unit Research and Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar

The main purpose of this study was to assess the accuracy of various techniques available for diagnosis of malaria. Blood samples were collected from 313 patients with clinical suspicion of uncomplicated malaria in 2 primary health centers in Madagascar. The presence of Plasmodium parasites was assessed by conventional microscopy, 2 rapid diagnostic tests (one HRP2-based test, PALUTOP+4, and one pLDH-based test, OptiMAL-IT), and real-time polymerase chain reaction (PCR), which is used as the "gold standard" method. The degree of agreement observed was very high for microscopy (0.99) and the HRP2-based test (0.93) and high for the pLDH-based test (0.82). Public-health implications are also discussed in this paper.

Received July 10, 2007. Accepted for publication October 17, 2007.

Acknowledgments: The authors thank the Ministry of Health of Madagascar for allowing us access to malaria patients and the patients for participating in the study.

Financial support: This work was supported by the Global Fund Project for Madagascar, Round 3 (Community Action to Roll Back Malaria, grant no. MDG-304-G05-M).

* Address correspondence to Didier Ménard, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar. E-mail: dmenard{at}pasteur.mg

Authors’ addresses: Hanitra Rakotonirina, Céline Barnadas, Rogelin Raherijafy, Hery Andrianantenaina, Martial Jahevitra, Valérie Andriantsoanirina, and Didier Ménard, Malaria Unit Research, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar, Telephone: +261 20 22 412 72, Fax: +261 20 22 415 34, E-mail: dmenard{at}pasteur.mg. Arsène Ratsimbasoa and Laurence Randrianasolo, Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.