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Comparative Study
. 2011 Nov 24:10:345.
doi: 10.1186/1475-2875-10-345.

Use of a pLDH-based dipstick in the diagnostic and therapeutic follow-up of malaria patients in Mali

Amed Ouattara  1 , Safiatou Doumbo, Renion Saye, Abdoul H Beavogui, Boubacar Traoré, Abdoulaye Djimdé, Amadou Niangaly, Kassoum Kayentao, Mouctar Diallo, Ogobara K Doumbo, Mahamadou A Thera
Affiliations
Comparative Study

Use of a pLDH-based dipstick in the diagnostic and therapeutic follow-up of malaria patients in Mali

Amed Ouattara et al. Malar J. .

Abstract

Background: Malaria is a major public health problem in Mali and diagnosis is typically based on microscopy. Microscopy requires a well trained technician, a reliable power source, a functioning microscope and adequate supplies. The scarcity of resources of community health centres (CHC) does not allow for such a significant investment in only one aspect of malaria control. In this context, Rapid Diagnostic Tests (RDTs) may improve case management particularly in remote areas.

Methods: This multicentre study included 725 patients simultaneously screened with OptiMal-IT test and thick smears for malaria parasite detection. While evaluating the therapeutic efficacy of choroquine in 2 study sites, we compared the diagnostic values of thick smear microscopy to OptiMal-IT test applying the WHO 14 days follow-up scheme using samples collected from 344 patients.

Results: The sensitivity and the specificity of OptiMal-IT compared to thick smear was 97.2% and 95.4%, whereas the positive and negative predictive values were 96.7 and 96.1%, respectively. The percent agreement between the two diagnostic tests was 0.93. The two tests were comparable in detecting malaria at day 0, day 3 and day 14. The only difference was observed at day 7 due to high gametocytemia. Subjectively, health care providers found OptiMal-IT easier to use and store under field conditions.

Conclusion: OptiMal-IT test revealed similar results when compared to microscopy which is considered the gold standard for malaria diagnostics. The test was found to have a short processing time and was easier to use. These advantages may improve malaria case management by providing a diagnostic and drug efficacy follow-up tool to peripheral health centres with limited resources.

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Figures

Figure 1
Figure 1
Study profile of study patients visit at study site. OptiMal-IT, thick smear test and drug efficacy follow-up outcome.
Figure 2
Figure 2
Dynamics of OptiMal-IT test positivity during patient follow-up after a malaria treatment. The day of follow-up is on the × axis and the proportion of positive cases on the y axis. Results from both tests were comparable during follow-up except for day 7 when the proportion of cases detected by OptiMal-IT was statistically higher compared to the proportion observed with thick smear
See this image and copyright information in PMC

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