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Orimadegun AE, Dada-Adegbola HO, Michael OS, Adepoju AA, Funwei RI, Olusola FI, Ajayi IO, Ogunkunle OO, Ademowo OG, Jegede AS, Baba E, Hamade P, Webster J, Chandramohan D, Falade CO. SD-Bioline malaria rapid diagnostic test performance and time to become negative after treatment of malaria infection in Southwest Nigerian Children. Ann Afr Med 2023; 22:470-480. [PMID: 38358148 PMCID: PMC10775936 DOI: 10.4103/aam.aam_220_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/10/2022] [Accepted: 12/09/2022] [Indexed: 02/16/2024] Open
Abstract
Context and Aim Given the challenges of microscopy, we compared its performance with SD-Bioline malaria rapid diagnostic test (MRDT) and polymerase chain reaction (PCR) and evaluated the time it took for positive results to become negative after treatment of children with acute uncomplicated malaria. Subjects and Methods We present the report of 485 participants with complete MRDT, microscopy, and PCR data out of 511 febrile children aged 3-59 months who participated in a cohort study over a 12-month period in rural and urban areas of Ibadan, Nigeria. MRDT-positive children received antimalaria and tested at every visit over 28 days. Speciation was also carried out by PCR. Results With microscopy as the gold standard, SD-Bioline™ had 95.2% sensitivity, 66.4% specificity, 67.5% positive predictive value (PPV), and 94.9 negative predictive value (NPV), while with PCR the findings were 84.3% sensitivity, 66.5% specificity, 72.7% PPV, and 80.1% NPV. PCR speciation of malaria parasites revealed 91.6% Plasmodium falciparum, 18.9% Plasmodium malariae, and 4.4% Plasmodium ovale. Among the 47 children with P. malariae infections, 66.0% were coinfected with P. falciparum, while 54.6% cases of P. ovale occurred as coinfections with P. falciparum. The median time to a negative MRDT was 23.2 days, while the median time to a negative malaria microscopy was 3.8 days. The two survival curves were significantly different. Conclusions The SD-BiolineTM MRDT performed well, with remarkable persistence of rapid test-positive for an average of 23 days post treatment. The prevalence of P. malaria is somewhat greater than expected.
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Affiliation(s)
| | | | - Obaro S. Michael
- Department of Pharmacology and Therapeutics, College of Medicine, Ibadan, Nigeria
| | | | | | | | - IkeOluwapo O. Ajayi
- Department of Epidemiology and Biostatistics, College of Medicine, Ibadan, Nigeria
| | | | - Olusegun George Ademowo
- Department of Pharmacology and Therapeutics, College of Medicine, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, Ibadan, Nigeria
| | - Ayodele Samuel Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Ebenezer Baba
- Malaria Consortium Regional Office for Africa, Kampala, Uganda
| | | | - Jayne Webster
- London School of Tropical Medicine and Hygiene, London, United Kingdom
| | | | - Catherine Olufunke Falade
- Department of Pharmacology and Therapeutics, College of Medicine, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, Ibadan, Nigeria
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Orimadegun AE, Dada-Adegbola HO, Michael OS, Adepoju AA, Funwei RE, Olusola FI, Ajayi IO, Ogunkunle OO, Ademowo OG, Jegede AS, Baba E, Hamade P, Webster J, Chandroman D, Falade CO. Non-Malaria Causes of Fever among under-5 Children with Negative Results for Malaria Rapid Diagnostic Test in South-Western Nigeria. J Trop Pediatr 2022; 68:6650742. [PMID: 35895093 DOI: 10.1093/tropej/fmac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although the global malaria burden is decreasing, there are still concerns about overdiagnosis of malaria and the danger of misdiagnosis of non-malaria causes of fever. Clinicians continue to face the challenge of differentiating between these causes despite the introduction of malaria rapid diagnostic tests (mRDTs). AIM To determine the prevalence and causes of non-malaria-caused fever in children in South-Western Nigeria. METHODS Secondary analysis of data obtained to evaluate the effect of restricting antimalarial treatment to positive mRDT children in rural and urban areas of southwest Nigeria. Clinical examinations, laboratory tests for malaria parasites (including thick blood film and mRDT) and bacterial identification were performed on children aged 3-59 months (n = 511). The non-malaria group comprised febrile children who had both negative mRDT and microscopy results, while the malaria group included those who were positive for either mRDT or microscopy. We compared the causes of fever among children with non-malaria fever and those with malaria. RESULTS The prevalence of non-malaria fever and bacteria-malaria co-infection was 37.2% and 2.0%, respectively. Non-malarial pathogens identified were viral (54.7%) and bacterial (32.1%) infections. The bacterial infections included bacteriaemia (2.7%), urinary tract infections (21.6%), skin infections (11.6%) and otitis media (2.6%). The leading bacterial isolates were Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumoniae. CONCLUSION The high prevalence and wide range of non-malarial infections reinforces the need for point-of-care tests to identify bacterial and viral infections to optimize the treatment of febrile illnesses in malaria-endemic areas.
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Affiliation(s)
- Adebola E Orimadegun
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Hannah O Dada-Adegbola
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Obaro S Michael
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adedayo A Adepoju
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Roland E Funwei
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Fiyinfoluwa I Olusola
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Biostatistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Olusegun G Ademowo
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodele S Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Ebenezer Baba
- Malaria Consortium Regional Office for Africa, Kampala, Uganda
| | | | - Jayne Webster
- Department of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, UK
| | - Daniel Chandroman
- Department of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, UK
| | - Catherine O Falade
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Falade CO, Mokuolu OA. The need for social group interventions to increase malaria rapid diagnostic test uptake in Nigeria. LANCET GLOBAL HEALTH 2021; 9:e231-e232. [DOI: 10.1016/s2214-109x(21)00032-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 01/10/2023]
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