1921
Volume 90, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Severe malaria is frequently managed without access to laboratory testing. We report on the performance of point-of-care tests used to guide the management of a cohort of 179 children with severe malaria in a resource-limited Ugandan hospital. Correlation coefficients between paired measurements for glucose (i-STAT and One Touch Ultra), lactate (i-STAT and Lactate Scout), and hemoglobin (Hb; laboratory and i-STAT) were 0.86, 0.85, and 0.73, respectively. The OneTouch Ultra glucometer readings deviated systematically from the i-STAT values by +1.7 mmol/L. Lactate Scout values were systematically higher than i-STAT by +0.86 mmol/L. Lactate measurements from either device predicted subsequent mortality. Hb estimation by the i-STAT instrument was unbiased, with upper and lower limits of agreement of −34 and +34 g/L, and it was 91% sensitive and 89% specific for the diagnosis of severe anemia (Hb < 50 g/L). New commercially available bedside diagnostic tools, although imperfect, may expedite clinical decision-making in the management of critically ill children in resource-constrained settings.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.13-0689
2014-04-02
2017-09-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/90/4/605.html?itemId=/content/journals/10.4269/ajtmh.13-0689&mimeType=html&fmt=ahah

References

  1. Murray CJ, Rosenfeld LC, Lim SS, Andrews KG, Foreman KJ, Haring D, Fullman N, Naghavi M, Lozano R, Lopez AD, , 2012. Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet 379: 413431.[Crossref]
  2. Kyu HH, Fernandez E, , 2009. Artemisinin derivatives versus quinine for cerebral malaria in African children: a systematic review. Bull World Health Organ 87: 896904.[Crossref]
  3. Diabetes Research in Children Network (Direcnet) Study Group, 2003. A multicenter study of the accuracy of the One Touch Ultra home glucose meter in children with type 1 diabetes. Diabetes Technol Ther 5: 933941.[Crossref]
  4. Arabadjief D, Nichols JH, , 2006. Assessing glucose meter accuracy. Curr Med Res Opin 22: 21672174.[Crossref]
  5. Chan JC, Wong RY, Cheung CK, Lam P, Chow CC, Yeung VT, Kan EC, Loo KM, Mong MY, Cockram CS, , 1997. Accuracy, precision and user-acceptability of self blood glucose monitoring machines. Diabetes Res Clin Pract 36: 91104.[Crossref]
  6. Demers J, Kane MP, Bakst G, Busch RS, Hamilton RA, , 2003. Accuracy of home blood glucose monitors using forearm blood samples: FreeStyle versus One Touch Ultra. Am J Health Syst Pharm 60: 11301135.
  7. Kilpatrick ES, McLeod MJ, Rumley AG, Small M, , 1994. A ward comparison between the One Touch II and Glucometer II blood glucose meters. Diabet Med 11: 214217.[Crossref]
  8. Rivers SM, Kane MP, Bakst G, Busch RS, Hamilton RA, , 2006. Precision and accuracy of two blood glucose meters: FreeStyle Flash versus One Touch Ultra. Am J Health Syst Pharm 63: 14111416.[Crossref]
  9. Gaieski DF, Drumheller BC, Goyal M, Fuchs BD, Shofer FS, Zogby K, , 2013. Accuracy of Handheld Point-of-Care Fingertip Lactate Measurement in the Emergency Department. West J Emerg Med 14: 5862.[Crossref]
  10. Hopfer SM, Nadeau FL, Sundra M, Makowski GS, , 2004. Effect of protein on hemoglobin and hematocrit assays with a conductivity-based point-of-care testing device: comparison with optical methods. Ann Clin Lab Sci 34: 7582.
  11. Moore CC, Jacob ST, Pinkerton R, Meya DB, Mayanja-Kizza H, Reynolds SJ, Scheld WM, , 2008. Point-of-care lactate testing predicts mortality of severe sepsis in a predominantly HIV type 1-infected patient population in Uganda. Clin Infect Dis 46: 215222.[Crossref]
  12. Steinfelder-Visscher J, Weerwind PW, Teerenstra S, Brouwer MH, , 2006. Reliability of point-of-care hematocrit, blood gas, electrolyte, lactate and glucose measurement during cardiopulmonary bypass. Perfusion 21: 3337.[Crossref]
  13. Wu P, Morey TE, Harris NS, Gravenstein N, Rice MJ, , 2013. Intravenous fluids cause systemic bias in a conductivity-based point-of-care hematocrit meter. Anesth Analg 114: 314321.[Crossref]
  14. Newton CR, Valim C, Krishna S, Wypij D, Olola C, Agbenyega T, Taylor TE, , 2005. The prognostic value of measures of acid/base balance in pediatric falciparum malaria, compared with other clinical and laboratory parameters. Clin Infect Dis 41: 948957.[Crossref]
  15. Hawkes M, Opoka RO, Namasopo S, Miller C, Conroy AL, Serghides L, Kim H, Thampi N, Liles WC, John CC, Kain KC, , 2011. Nitric oxide for the adjunctive treatment of severe malaria: hypothesis and rationale. Med Hypotheses 77: 437444.[Crossref]
  16. Hawkes M, Opoka RO, Namasopo S, Miller C, Thorpe KE, Lavery JV, Conroy AL, Liles WC, John CC, Kain KC, , 2011. Inhaled nitric oxide for the adjunctive therapy of severe malaria: protocol for a randomized controlled trial. Trials 12: 176.[Crossref]
  17. Dondorp AM, Fanello CI, Hendriksen IC, Gomes E, Seni A, Chhaganlal KD, Bojang K, Olaosebikan R, Anunobi N, Maitland K, Kivaya E, Agbenyega T, Nguah SB, Evans J, Gesase S, Kahabuka C, Mtove G, Nadjm B, Deen J, Mwanga-Amumpaire J, Nansumba M, Karema C, Umulisa N, Uwimana A, Mokuolu OA, Adedoyin OT, Johnson WB, Tshefu AK, Onyamboko MA, Sakulthaew T, Ngum WP, Silamut K, Stepniewska K, Woodrow CJ, Bethell D, Wills B, Oneko M, Peto TE, von Seidlein L, Day NP, White NJ, , 2010. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet 376: 16471657.[Crossref]
  18. Rebel A, Rice MA, Fahy BG, , 2012. Accuracy of point-of-care glucose measurements. J Diabetes Sci Technol 6: 396411.[Crossref]
  19. Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC, , 2004. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 32: 16371642.[Crossref]
  20. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, , 2001. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345: 13681377.[Crossref]
  21. Steinfelder-Visscher J, Weerwind PW, Teerenstra S, Pop GA, Brouwer RM, , 2007. Conductivity-based hematocrit measurement during cardiopulmonary bypass. J Clin Monit Comput 21: 712.[Crossref]
  22. Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P, Akech SO, Nyeko R, Mtove G, Reyburn H, Lang T, Brent B, Evans JA, Tibenderana JK, Crawley J, Russell EC, Levin M, Babiker AG, Gibb DM, , 2011. Mortality after fluid bolus in African children with severe infection. N Engl J Med 364: 24832495.[Crossref]
  23. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A, , 1989. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. Q J Med 71: 441459.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.13-0689
Loading
/content/journals/10.4269/ajtmh.13-0689
Loading

Data & Media loading...

  • Received : 28 Nov 2013
  • Accepted : 23 Dec 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error