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Am. J. Trop. Med. Hyg., 82(1), 2010, pp. 145-147
doi:10.4269/ajtmh.2010.09-0408;
Copyright © 2010 by The American Society of Tropical Medicine and Hygiene

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BRIEF-REPORT


Utility of a Point-of-Care Malaria Rapid Diagnostic Test for Excluding Malaria as the Cause of Fever among HIV-Positive Adults in Rural Rakai, Uganda

Lisa A. Mills*, Joseph Kagaayi, Gertrude Nakigozi, Ronald M. Galiwango, Joseph Ouma, Joseph P. Shott, Victor Ssempijja, Ronald H. Gray, Maria J. Wawer, David Serwadda, Thomas C. Quinn, AND Steven J. Reynolds
Johns Hopkins School of Medicine, Division of Infectious Diseases, Baltimore, Maryland; Rakai Health Sciences Program, Kalisizo, Uganda; Clinical Monitoring Research Program, SAIC-Frederick, Inc., NCI-Frederick, Frederick, Maryland; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Makerere University Institute of Public Health, Kampala, Uganda; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland

 

ABSTRACT

We compared results of a malaria rapid diagnostic test (Binax Now® Malaria, Binax-M, Inverness Medical Innovations, Inc., Waltham, MA) performed at rural mobile clinics in Uganda by clinicians evaluating febrile adult HIV patients to thick smear evaluated at a central laboratory by trained microscopists. Two hundred forty-six samples were analyzed, including 14 (5.7%) which were thick-smear positive for falciparum malaria. Sensitivity of Binax-M compared with thick smear was 85.7% (95% CI: 57.2–98.2), specificity 97.8% (95% CI: 94.9–99.3), positive and negative predictive values were 70.6% (95% CI: 44.0–89.7) and 99.1% (95% CI: 96.8–99.9), respectively. The rapid diagnostic test accurately ruled malaria "in or out" at the point-of-care, facilitating appropriate clinical management and averting unnecessary anti-malarial therapy.

Received July 19, 2009. Accepted for publication September 8, 2009.

 

Acknowledgments:

The authors thank the field teams of Rakai Health Sciences Program and the study participants. The American Committee on Clinical Tropical Medicine and Travelers' Health (ACCTMTH) assisted with publication expenses.

Financial support: This project has been funded in whole or in part with federal funds from the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, and the National Cancer Institute, National Institutes of Health, under Contract Number HHSN261200800001E.

Disclaimer: The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of any trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Authors' addresses: Lisa A. Mills, Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, E-mail: lmills{at}ke.cdc.gov. Joseph Kagaayi, Gertrude Nakigozi, Ronald M. Galiwango, Joseph Ouma, and Victor Ssempijja, Rakai Health Sciences Program, Kalisizo, Rakai District, Uganda, E-mails: JKagayi{at}rhsp.org, FTrudie{at}yahoo.com, RMGaliwango{at}rhsp.org, Oumaotobi{at}yahoo.com, and VSsempijja{at}gmail.com. Joseph P. Shott, SAIC-Frederick, Inc., Support to DIR/NIAID/NIH, Bethesda, MD, E-mail: ShottJ{at}mail.nih.gov. Maria J. Wawer and Ronald H. Gray, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mails: MWawer{at}jhsph.edu and RGray{at}jhsph.edu. David Serwadda, Makerere University Institute of Public Health, IPH Building—New Mulago Complex, Kampala, Uganda, E-mail: DSerwada{at}infocom.co.ug. Thomas C. Quinn and Steven J. Reynolds, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, E-mails: TQuinn{at}jhmi.edu and SJR{at}jhmi.edu.

*Address correspondence to Lisa A. Mills, Division of Infectious Diseases, Johns Hopkins Medical Institutions, 1830 East Monument Street, Room #401, Baltimore, MD 21287. E-mail: LMills{at}ke.cdc.gov




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Utility of Point-of-Care Malaria Rapid Diagnostic Tests
Am J Trop Med Hyg, July 1, 2010; 83(1): 207 - 207.
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