Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon
Abstract Background The need to start treatment early for pregnant women who present with clinical features of malaria usually conflicts with the need to confirm diagnosis by microscopy (MP) before treatment, due to delays in obtaining results. Parasite sequestration in the placenta is also a proble...
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ftdoajarticles:oai:doaj.org/article:66166860209a4da38845cc87a2507918 2023-05-15T15:18:25+02:00 Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon Cliford Ebontane Ebong Innocent Mbulli Ali Hortence Jeanne Fouedjio Estelle Essangui Dorothy Fosah Achu Ayong Lawrence Dohbit Sama 2022-03-01T00:00:00Z https://doi.org/10.1186/s12936-022-04109-6 https://doaj.org/article/66166860209a4da38845cc87a2507918 EN eng BMC https://doi.org/10.1186/s12936-022-04109-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04109-6 1475-2875 https://doaj.org/article/66166860209a4da38845cc87a2507918 Malaria Journal, Vol 21, Iss 1, Pp 1-8 (2022) Malaria Pregnancy CareStart pf/PAN RDT Sensitivity Yaoundé Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1186/s12936-022-04109-6 2022-12-31T14:30:31Z Abstract Background The need to start treatment early for pregnant women who present with clinical features of malaria usually conflicts with the need to confirm diagnosis by microscopy (MP) before treatment, due to delays in obtaining results. Parasite sequestration in the placenta is also a problem. Rapid diagnostic tests (RDT), which detect soluble antigens, are a valuable alternative. The objective of this study was to evaluate pretreatment parasite prevalence by microscopy and by RDT and to assess the accuracy of RDT with MP as reference. Methods A prospective cross-sectional study was carried out at the obstetrical unit of the Central Hospital in Yaoundé, during the period January-August 2015. Consenting patients with symptoms of suspected malaria in pregnancy were recruited and a blood sample taken for MP and RDT before treatment was started. The estimates of diagnostic performance (with 95% confidence interval) were calculated in OpenEpi online software using the Wilson’s score. The agreement, as reflected by the Cohen’s kappa, was calculated and interpreted using known intervals. Results The results showed that, out of the 104 patients recruited, 69.2% (95%CI: 59.1–77.5) were MP positive while 77.94% (95%CI: 63.1–80.9) were RDT positive. The sensitivity of the malaria RDT was 91.67% (95%CI: 83.69–96.77) while the specificity was 53.13% (95%CI: 31.39–65.57). The diagnostic accuracy of the RDT with MP as reference was 79.81% (95%CI: 70.0–86.1). All cases were due to Plasmodium falciparum. A Cohen’s kappa of 0.45 (95%CI: 0.26–0.64) was obtained, consistent with a moderate agreement between the tests. Conclusions The diagnostic accuracy of the CareStart™ malaria Pf/PAN compared to microscopy was high, but not as desirable, with a false negative RDT at very high parasitaemia. In tertiary facilities, RDTs appear to provide a better diagnostic solution compared to microscopy. However, future studies with larger sample sizes should make this observation more generalizable; as missing a case could have serious ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 21 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Malaria Pregnancy CareStart pf/PAN RDT Sensitivity Yaoundé Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Pregnancy CareStart pf/PAN RDT Sensitivity Yaoundé Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Cliford Ebontane Ebong Innocent Mbulli Ali Hortence Jeanne Fouedjio Estelle Essangui Dorothy Fosah Achu Ayong Lawrence Dohbit Sama Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
topic_facet |
Malaria Pregnancy CareStart pf/PAN RDT Sensitivity Yaoundé Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The need to start treatment early for pregnant women who present with clinical features of malaria usually conflicts with the need to confirm diagnosis by microscopy (MP) before treatment, due to delays in obtaining results. Parasite sequestration in the placenta is also a problem. Rapid diagnostic tests (RDT), which detect soluble antigens, are a valuable alternative. The objective of this study was to evaluate pretreatment parasite prevalence by microscopy and by RDT and to assess the accuracy of RDT with MP as reference. Methods A prospective cross-sectional study was carried out at the obstetrical unit of the Central Hospital in Yaoundé, during the period January-August 2015. Consenting patients with symptoms of suspected malaria in pregnancy were recruited and a blood sample taken for MP and RDT before treatment was started. The estimates of diagnostic performance (with 95% confidence interval) were calculated in OpenEpi online software using the Wilson’s score. The agreement, as reflected by the Cohen’s kappa, was calculated and interpreted using known intervals. Results The results showed that, out of the 104 patients recruited, 69.2% (95%CI: 59.1–77.5) were MP positive while 77.94% (95%CI: 63.1–80.9) were RDT positive. The sensitivity of the malaria RDT was 91.67% (95%CI: 83.69–96.77) while the specificity was 53.13% (95%CI: 31.39–65.57). The diagnostic accuracy of the RDT with MP as reference was 79.81% (95%CI: 70.0–86.1). All cases were due to Plasmodium falciparum. A Cohen’s kappa of 0.45 (95%CI: 0.26–0.64) was obtained, consistent with a moderate agreement between the tests. Conclusions The diagnostic accuracy of the CareStart™ malaria Pf/PAN compared to microscopy was high, but not as desirable, with a false negative RDT at very high parasitaemia. In tertiary facilities, RDTs appear to provide a better diagnostic solution compared to microscopy. However, future studies with larger sample sizes should make this observation more generalizable; as missing a case could have serious ... |
format |
Article in Journal/Newspaper |
author |
Cliford Ebontane Ebong Innocent Mbulli Ali Hortence Jeanne Fouedjio Estelle Essangui Dorothy Fosah Achu Ayong Lawrence Dohbit Sama |
author_facet |
Cliford Ebontane Ebong Innocent Mbulli Ali Hortence Jeanne Fouedjio Estelle Essangui Dorothy Fosah Achu Ayong Lawrence Dohbit Sama |
author_sort |
Cliford Ebontane Ebong |
title |
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
title_short |
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
title_full |
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
title_fullStr |
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
title_full_unstemmed |
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon |
title_sort |
diagnosis of malaria in pregnancy: accuracy of carestart™ malaria pf/pan against light microscopy among symptomatic pregnant women at the central hospital in yaoundé, cameroon |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s12936-022-04109-6 https://doaj.org/article/66166860209a4da38845cc87a2507918 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 21, Iss 1, Pp 1-8 (2022) |
op_relation |
https://doi.org/10.1186/s12936-022-04109-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04109-6 1475-2875 https://doaj.org/article/66166860209a4da38845cc87a2507918 |
op_doi |
https://doi.org/10.1186/s12936-022-04109-6 |
container_title |
Malaria Journal |
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21 |
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1 |
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1766348615378272256 |