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 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

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Joseph Kagaayi 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

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Gertrude Nakigozi 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

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Ronald M. Galiwango 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

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Joseph Ouma 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

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Joseph P. Shott 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

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Victor Ssempijja 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

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Ronald H. Gray 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

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Maria J. Wawer 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

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David Serwadda 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

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Thomas C. Quinn 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

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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

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DOI:
https://doi.org/10.4269/ajtmh.2010.09-0408
Volume/Issue:
Volume 82: Issue 1
Page(s):
145–147
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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.

Author Notes

*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@ke.cdc.gov

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@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@rhsp.org, FTrudie@yahoo.com, RMGaliwango@rhsp.org, Oumaotobi@yahoo.com, and VSsempijja@gmail.com. Joseph P. Shott, SAIC-Frederick, Inc., Support to DIR/NIAID/NIH, Bethesda, MD, E-mail: ShottJ@mail.nih.gov. Maria J. Wawer and Ronald H. Gray, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mails: MWawer@jhsph.edu and RGray@jhsph.edu. David Serwadda, Makerere University Institute of Public Health, IPH Building—New Mulago Complex, Kampala, Uganda, E-mail: DSerwada@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@jhmi.edu and SJR@jhmi.edu.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2010
Received:
19 Jul 2009
|
Accepted:
08 Sep 2009
|
Published Online:
05 Jan 2010
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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