Clinical overlap between malaria and pneumonia: can malaria rapid diagnostic test play a role?
نویسندگان
چکیده
INTRODUCTION Malaria and pneumonia account for 40% of mortality among children under five years of age in sub-Saharan Africa. Due to lack of diagnostic facilities, their management is based on the integrated management of childhood illnesses (IMCI) strategy. Symptoms of malaria and pneumonia overlap in African children, necessitating dual IMCI classifications at health centres and treatment with both antibiotics and antimalarials. This study determined the prevalence of malaria-pneumonia symptom overlap and confirmed the diagnosis of malaria in these cases using a rapid diagnostic test. METHODOLOGY Consecutive consultations of 1,216 children (two months to five years old) were documented over a three-month period in a comprehensive health centre. Malaria rapid diagnostic tests were conducted only for children who had symptom overlap. RESULTS Of the 1,216 children enrolled, 1,090 (90%) reported cough or fever. Among the children fulfilling the malaria case definition, 284 (30%) also met the pneumonia case definition. Twenty-three percent (284) of all children enrolled met the criteria for both malaria and pneumonia. However, only 130 (46%) of them had a positive result for malaria using a malaria rapid diagnostic test. During a malaria-pneumonia overlap, female children (chi-square 5.9, P = 0.01) and children ≥ one year (chi-square 4.8, P = 0.003) were more likely to seek care within two days of fever. CONCLUSION Dual treatment with antimalarials and antibiotics in children with malaria-pneumonia overlap may result in unnecessary over-prescription of antimalarial medications. Use of rapid diagnostic tests in their management can potentially avoid over-prescribing of malaria medications.
منابع مشابه
Outcome of Presumptive Versus Rapid Diagnostic Tests-Based Management of Childhood Malaria - Pneumonia Overlap in Urban Nigeria: A Pilot Quasi-Experimental Study
BACKGROUND Symptoms of malaria and pneumonia overlap in African under-five children and the integrated management of childhood illness strategy require that such children be managed presumptively with both antibiotics and antimalarials. A 2003 WHO expert meeting recommended the evaluation of malaria rapid diagnostic test in the management of children with this overlap, but this has not been eva...
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ورودعنوان ژورنال:
- Journal of infection in developing countries
دوره 5 3 شماره
صفحات -
تاریخ انتشار 2011